Gundersen Flap Removal to Restore Eyesight Without Limbal Transplantation-A Case Report.

PURPOSE: To report a case of Gundersen flap removal where the ocular surface was restored without the need for additional limbal stem cell transplantation. METHODS: We describe a case of 57-year-old man who underwent Gundersen flap for a nonhealing corneal ulcer in right eye 17 years ago. He recently lost eyesight in left eye after blunt trauma. Gundersen flap removal was performed in right eye along with amniotic membrane transplantation. RESULTS: The ocular surface recovered completely after surgery without any evidence of limbal stem cell deficiency. His corrected distance visual acuity improved to 20/60 along with a stable ocular surface, which was maintained till last follow-up of 12 months. CONCLUSIONS: A normal ocular surface can be restored after Gundersen flap surgery if removal of limbal epithelium is not performed during the primary procedure. Additional corneal surgery might be required depending on corneal clarity.

Customized toric intraocular lens implantation in cornea plana.

A 50-year-old woman with cornea plana had reduced visual acuity due to development of lenticular changes. Flat keratometry with high astigmatism, shallow anterior chamber depth, and short axial length made it challenging both for intraocular lens (IOL) power calculation and cataract surgery. Surgery was planned for the right eye because the left eye was densely amblyopic. IOL power required was beyond the commercially available lenses; hence, a customized toric IOL was obtained. Phacoemulsification was successfully performed along with in-the-bag implantation of the toric IOL, which resulted in improved visual acuity with satisfactory refractive outcome. Cataract surgery with a customized IOL improved visual acuity in an eye with cornea plana.