# Immediate Bilateral Sequential Keratoplasty in a 13‐Year‐Old Boy With Perforated Corneal Ulcer Secondary to Exposure Keratopathy

## TL;DR

A 13-year-old boy with severe eye injuries received immediate eye transplants in both eyes, showing successful recovery with no complications.

## Contribution

This is the first reported case of immediate sequential bilateral penetrating keratoplasty in a pediatric patient.

## Key findings

- Immediate sequential bilateral penetrating keratoplasty was performed successfully in a 13-year-old with bilateral corneal perforations.
- No signs of graft rejection or infection were observed over a 6-month follow-up period.
- The approach proved to be a reasonable and effective treatment for emergent bilateral corneal perforation.

## Abstract

To present the challenging scenario of a 13‐year‐old patient in the ICU with bilateral corneal perforations secondary to EK, who underwent immediate sequential bilateral penetrating keratoplasty. Furthermore, we explore the treatment outcomes of this approach. A 13‐year‐old boy presented with decreased vision in both eyes. Upon ophthalmic examination, we identified bilateral perforated corneal ulcers with iris prolapse and a flat anterior chamber (AC). Due to the bilateral corneal perforations and the heightened risk of infectious endophthalmitis, immediate bilateral sequential penetrating keratoplasty (PKP) was carried out for the patient the day after presentation to our emergency room (ER). Over the 6‐month follow‐up period, no signs of graft rejection or infection were observed. This is the first reported case of immediate sequential bilateral PK. In emergent situations like bilateral corneal perforation, sequential bilateral surgery proves to be a reasonable and effective option.