Treatment of anterior corneal scarring, following DSAEK graft failure, with combined graft exchange and phototherapeutic keratectomy

BACKGROUND: To present a method, alternative to penetrating keratoplasty, for the restoration of impaired corneal clarity with anterior stromal scarring following long-standing corneal graft failure. CASE PRESENTATION: A 48-year old female who had previously underwent Descemet stripping automated endothelial keratoplasty (DSAEK) for the treatment of pseudophakic bullous keratopathy, presented with long-standing corneal oedema and anterior corneal scarring. A significant improvement in corrected distance visual acuity was demonstrated, as corneal clarity was restored following graft exchange and phototherapeutic keratectomy (PTK). CONCLUSIONS: The combination of corneal graft exchange and phototherapeutic keratectomy may represent an effective therapeutic option for long-standing corneal oedema with concomitant anterior corneal scarring after failure of a DSAEK graft.