Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors

Figure 5

Patient 4 before surgery and after uveo-sclero-corneal block excision. (a) Epithelial iris cysts between the 8 and 12 o’clock positions of the right eye, involving the anterior chamber angle, partially stretching the pupil foramen. (b) UBM transversal scan at the 11 o’clock position (T11) showing multiple optically empty cysts into the anterior chamber occluding the chamber angle, in contact with the corneal endothelium. (c) UBM axial scan at the 12 o’clock position (A12) showing how the large cyst touches the equator and the anterior surface of the lens. (d) Removal of the major cyst at 12 o’clock after creating a scleral fornix-based flap and a limbal incision to enter into the anterior chamber. (e) Block excision of cysts from 8 to 11 o’clock after core dry vitrectomy and manual incision of the marked sclera with a diamond knife. Viscoelastic substance is injected into the anterior chamber. (f) Corneal graft is sutured to the sclera and to the patient’s cornea with interrupted Nylon 10.0 sutures. (g) Corneal graft is clear two years after surgery. Sutures are still in situ. (h, i) Perfect integrity of the cyst’s wall after block excision, outlined by the inner surface of cornea, angle, iris, and ciliary body. The empty, clear spaces outlined by the cyst’s walls are related to the cyst’s serous content.

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