PK-SMART: Penetrating Keratoplasty With Sutureless Membrane Artificial Endothelial Replacement Technique. Report of the First Three Clinical Cases.
Luigi Fontana, Vito Romano, Natalie di Geronimo et al.
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Case in brief
Three patients with a history of failed penetrating keratoplasty and multiple ocular surgeries underwent a novel surgical technique, PK-SMART, which combines penetrating keratoplasty with sutureless artificial endothelial replacement. At six months post-surgery, all grafts were clear, and visual acuity improved significantly, with central corneal thickness decreasing in all cases. No postoperative complications were reported.
Diagnostic / clinical pearl
The PK-SMART technique effectively addresses both stromal opacities and endothelial dysfunction in high-risk eyes, offering a promising option for patients with complex ocular histories.
Why it matters
This case highlights the potential of combining penetrating keratoplasty with artificial endothelial replacement in challenging scenarios, which may improve outcomes in patients at high risk for graft failure.