Bilateral autologous penetrating keratoplasty following periorbital necrotising fasciitis.

The case report describes a rare instance of a man in his 70s with periorbital necrotising fasciitis (NF) who underwent bilateral autologous penetrating keratoplasty. NF is an acute infection that can lead to severe complications, including vision loss. The patient presented with severe facial swelling and necrosis of the right eyelid, treated with surgical debridement and antibiotics. Post-surgery, he lost vision in the right eye due to compressive optic neuropathy and developed exposure keratopathy, which was managed with tarsorrhaphy. His left eye had poor vision due to herpetic corneal scarring. He met the criteria for a bilateral autologous keratoplasty, transferring his healthy right cornea to his otherwise healthy left eye and the damaged left cornea to the right eye. The surgery was successful, and at 9 months post-operation, the patient achieved improved vision (6/36) and is awaiting contact lens fitting. The report highlights the advantages and considerations of autokeratoplasty over conventional corneal transplants.