Manual Intracorneal Silicone Oil Insertion for Symptomatic Treatment of Bullous Keratopathy in a Patient with Corneal Scarring

Bullous keratopathy is a result of endothelial loss and the failure of the remaining corneal epithelium to pump leaking water molecules away from the corneal tissue, causing overhydration. In eyes with good visual potential, keratoplasty is the primary treatment. There are also several other approaches to provide temporary improvement until a permanent solution with keratoplasty can be achieved. These alternatives include hypertonic topical sodium chloride (5%) drops, bandage contact lenses, anterior stromal puncture, phototherapeutic keratectomy, amniotic membrane transplantation, conjunctival flaps, and collagen crosslinking. This case report is a description of a different surgical technique using manual lamellar corneal dissection and intrastromal silicone oil insertion to provide symptomatic treatment of bullous keratopathy in an eye with no light perception and significant corneal scarring.