DMEK
Selective transplantation of Descemet’s membrane and endothelium only
Host stroma preserved - reduced rejection rates
What is Mooren’s ulcer
Rare form of Peripheral Ulcerative Keratitis
Autoimmune
Associated with hepatitis C
2 forms
Limited - middle age Caucasial patients, unilateral, responsive to treatment
Aggressive - young African - bilateral, resistant to treatment
Pain, progressive peripheral ulceration, leading edge to ulcer undermining epithelium, grey infiltrate at leading edge, stromal melt, no limbal clear zone, no scleritis
TREat with topical steroids, PO steroids, cyclophosphamide, ciclosporin
Lamellar keratoplasty
What is pterygium
Triangular fibrovascular band which arises from nasal limbus and grows across cornea
M>F
Dry climates, High UV
Elastic degeneration of collagen with destruction of Bowman’s layer
Adherent to whole legnth of underlying tissue
Conj melanoma
Most common site
Mets?
Poor prognosis?
Grey/black/nonpigmented vascularised nodule fixed to episclera
Mets to lymph nodes, lung, liver, brain
Poor prog:
Not involving limbus
Multifocal
Caruncle/fornix/palpebral
Thickness>1mm
Recurrence
Pagetoid/lymphatic/oribital spread
De novo (not PAM or naevus)
What is Stocker line?
Iron line just anterior to margin of pterygium - sign of chronicity
