Successful management of aniridic ocular surface disease with long-term bandage contact lens wear.
OBJECTIVE
To present an aniridic patient with failed penetrating keratoplasties OU (PK) who underwent successful repeat PK OD, which has remained clear for 4 years with continuous bandage lens (BCL) wear.


METHODS
A 73-year-old aniridic woman who had a failed PK complicated by ocular surface disease refused limbal stem cell transplantation and underwent repeat PK in her right eye. The immediate postoperative course was uneventful except for mild irregularity of the graft epithelium. Two months postoperatively, she presented with an epithelial defect along the inferotemporal graft margin adjacent to an exposed, loose interrupted suture. The suture was removed, and although the initial epithelial defect healed, she suffered recurrent episodes of epithelial breakdown and generalized whorl epitheliopathy. A BCL was inserted and rendered prompt healing of the graft epithelium, which has remained smooth and intact for 4 years.


RESULTS
The graft remains thin and clear with a smooth and intact epithelial surface beneath the BCL and no signs of limbal stem-cell deficiency.


CONCLUSIONS
Long-term BCL wear provided good corneal transplant surface protection in an aniridic patient with recurrent epithelial breakdown, thereby sparing the need for limbal stem cell transplantation and the use of potentially toxic systemic immunosuppressive therapy. Meticulous follow-up is required to monitor contact lens loss and epithelial breakdown as well as signs of secondary infectious keratitis.
Ozbek
Zeynep
Z
Cornea Service Wills Eye Hospital, Philadelphia, PA, USA.
Raber
Irving M
IM
D000368:Aged; D015783:Aniridia / Q000628:therapy*; D003262:Contact Lenses, Extended-Wear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating; D011474:Prosthesis Design; D012683:Sensory Deprivation; D013997:Time Factors; D017211:Treatment Failure