Penetrating keratoplasty in megalophthalmos

A 33-year-old white woman was referred for treatment of a painful left eye in 1964. She underwent an 11 mm corneal transplant for bullous keratopathy and did well until 1982 when a transplant was performed on the right eye for similar problems. Examination revealed grossly enlarged globes with corneal diameters of greater than 22 mm with enlarged anterior segments and bullous keratopathy. Following the first transplant the patient had useful vision throughout 18 years follow-up. A brief discussion of enlarged anterior segments is presented along with a pathological description of the corneal button of the right eye.