UNASSIGNED: To report a challenging case of corneal descemetocele following Nd:YAG laser capsulotomy for posterior capsule opacification in a patient with Steven Johnson syndrome (SJS).
UNASSIGNED: A single-eye 52 year-old man, with a history of Steven Johnson syndrome, presented with severe eye pain and profound vision reduction in his left eye two days after undergoing Nd:YAG laser capsulotomy using the standard Abraham contact lens. A corneal descemetocele was identified and subsequently confirmed by anterior segment optical coherence tomography. He was promptly treated with the application of a therapeutic contact lens and sustained antibiotic regimen (preservative-free fluoroquinolone drops every 4 hours for 6 weeks) until healing of the corneal epithelium. Throughout the following eight weeks AS-OCT showed favorable anatomical and functional outcomes, achieving a substantial spontaneous healing.
UNASSIGNED: Corneal descemetocele may occur after Nd:YAG laser capsulotomy in patients with Steven Johnson syndrome. This case strengthens the critical importance of a careful preoperative assessment and meticulous postoperative management in high-risk patients, such as those with Steven Johnson syndrome, even after seemingly routine and safe ophthalmic procedures.

Background: Chronic ocular graft-versus-host disease (oGVHD) is a common ocular complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), characterized by progressive inflammation of the ocular surface and refractory dry eye. In severe cases, sterile corneal perforation can occur, which poses a significant challenge, due to the low survival rate of grafts after corneal transplantation. Case Presentation: A 47-year-old female presented to our hospital with persistent dryness, foreign body sensation, and blurred vision in her left eye. Diagnosis of graft-versus-host disease with corneal descemetocele in the left eye was made after detailed history review and thorough examination. Multi-layer amniotic membrane transplantation was performed in the affected eye, resulting in amelioration of the patient\'s symptoms. This amelioration of symptoms provided the patient with a level of comfort that permitted additional time while awaiting corneal transplantation. Conclusions: We report a successful case of multi-layer amniotic membrane transplantation for the management of corneal descemetocele following allo-HSCT.

OBJECTIVE: To compare the surgical outcomes of amniotic membrane transplantation (AMT) and penetrating keratoplasty (PK) in perforated and non-perforated corneal descemetocele.
METHODS: In this study, we retrospectively examined 48 eyes of 48 patients operated with AMT, and 32 eyes of 32 patients operated with PK for perforated and non-perforated descemetocele.
RESULTS: There were no significant differences between the two groups with regard to age, sex, laterality, follow-up duration, cause of descemetocele, and localization (p > 0.05). Thirty-six (75%) eyes in the AMT group and 17 (53.1%) eyes in the PK group were perforated prior to operation (p = 0.043). Surgical success was achieved in 35 (73%) of 48 eyes underwent AMT and 28 (87.5%) of 32 eyes underwent PK (p = 0.118). Perforation size was the only parameter significantly affecting surgical success (AMT p = 0.001, PK p = 0.003). The visual acuity was significantly better at the postsurgical period compared to the presurgical period in both groups (p = 0.003, p < 0.001). It was observed that the postsurgical change in the visual acuity score was significantly greater in the PK group (p = 0.001).
CONCLUSIONS: Penetrating keratoplasty is superior to AMT for achieving ocular surface integrity and enhancing visual acuity. Amniotic membrane transplantation saves time for patients and surgeons when donor cornea supply is limited and it allows PK to be performed at a quiet period when inflammation is suppressed.