Deep Anterior Lamellar Keratoplasty and Peripheral Lamellar Keratoplasty for a Case of Severe Peripheral Ulcerative Keratitis

We experienced a rare case of severe peripheral ulcerative keratitis in a patient undergoing surgery combined with deep anterior lamellar keratoplasty (DALK) and peripheral lamellar keratoplasty (LK). A 63-year-old Japanese woman was referred to our hospital for the treatment of visual disturbance caused by peripheral ulcerative keratitis in the left eye. Although the inflammation subsided with topical and oral administration of steroids, peripheral ulcerative keratitis worsened 4 weeks after the medical treatment. Surgery combining DALK and peripheral LK, including the corneal limbus, was performed as treatment. Two weeks after the surgery, a double anterior chamber appeared, but it disappeared spontaneously. There was no postoperative rejection or intraocular pressure elevation. One year and 6 months after the surgery, the inflammation did not recur, the cornea remained transparent, and the thickness of the cornea was maintained. In conclusion, combined DALK and peripheral LK may be a surgical option for treating severe peripheral ulcerative keratitis.