A 33-year-old man presented with a four-day history of redness and blurring of vision of the right eye. A clinical diagnosis of adenoviral keratitis was made with a differential of microsporidia epithelial keratitis. The patient subsequently developed nummular keratitis which was resistant to topical steroids. He continued to develop multiple recurrences of the condition. Treatment with tacrolimus ointment was started as the patient had an elevated intraocular pressure due to prolonged steroid use. Tacrolimus ointment showed a favourable outcome in the management of recurrent nummular keratitis.

The existing shortage of local donor corneas in our institution (University Malaya) and Malaysia, in general, prompted us to attempt the use of one donor cornea for two transplantation procedures; Descemet Stripping Endothelial Keratoplasty (DSEK) in a case of a pseudophakic bullous keratopathy (PBK) with underlying Fuchs endothelial dystrophy (FED) and lamellar patch graft in a case of limbal dermoid. The donor cornea was divided into anterior and posterior lamellae manually. The anterior corneal button was used as a patch graft for anterior lamellar keratoplasty in a 6-year-old patient with limbal dermoid, and the posterior corneal button was used for a DSEK procedure in a 68-year-old patient with corneal decompensation. Both patients had a stable and good visual outcome throughout a 1-year postoperative period. This allows the use of one corneal tissue by more than one recipient to overcome the shortage in donor corneas.
Transplants