{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:11:55Z","timestamp":1791961915955,"version":"4.3.4"},"reference-count":13,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,21]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>A 32-year-old man presented with bilateral diminution of vision for 10 years. Visual acuity was light perception in both eyes with inaccurate projection in the oculus dextrus(OD) and accurate projection in the in oculus sinister (OS). Intraocular pressure was 6 and 12\u2009mm\u2009Hg in the OD and OS, respectively. Slit-lamp examination revealed the presence of leucomatous corneal opacification with microcornea in oculus uterque (OU). Both eyes had a dislocated nucleus in the vitreous cavity on ultrasound B-scan with advanced cupping in the right eye. Ultrasound biomicroscopy revealed ciliary body atrophy in the OD and preserved ciliary processes (two quadrants) in the OS. In view of a partially preserved ciliary body function and a potential for gaining useful vision, we planned surgical intervention in the left eye. Deep anterior lamellar keratoplasty with pars planavitrectomy (PPV) and phacofragmentation of the nucleus was done. Donor lamellar graft was sutured after completion of PPV and nucleus fragmentation. The patient regained useful ambulatory vision postoperatively with clear corneal graft.<\/jats:p>","DOI":"10.1136\/bcr-2019-229397","type":"journal-article","created":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T06:45:17Z","timestamp":1560926717000},"page":"e229397","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Management of dislocated nucleus with corneal opacity by combined deep anterior lamellar keratoplasty, pars- plana vitrectomy and phaco-fragmentation"],"prefix":"10.1136","volume":"12","author":[{"given":"Samendra","family":"Karkhur","sequence":"first","affiliation":[{"name":"Vitreo-Retina and Uvea Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alok","family":"Sen","sequence":"additional","affiliation":[{"name":"Vitreo-Retina and Uvea Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Parmar","sequence":"additional","affiliation":[{"name":"Department of Cornea and Refractive Surgery, Shri Sadguru Seva Sangh Trust Chitrakoot Centre, Chitrakoot, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyavrat","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Vitreo-Retina and Uvea Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"2025082803125177000_12.6.e229397.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsb.2009.03.012"},{"key":"2025082803125177000_12.6.e229397.2","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.survophthal.2018.04.001","article-title":"Occult globe rupture: diagnostic and treatment challenge","volume":"63","author":"Chronopoulos","year":"2018","journal-title":"Surv Ophthalmol"},{"key":"2025082803125177000_12.6.e229397.3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/0002-9394(81)90168-9","article-title":"Clinical and research aspects of subtotal open-sky vitrectomy","volume":"91","author":"Schepens","year":"1981","journal-title":"Am J Ophthalmol"},{"key":"2025082803125177000_12.6.e229397.4","doi-asserted-by":"publisher","DOI":"10.1076\/soph.16.3.119.4199"},{"key":"2025082803125177000_12.6.e229397.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/ICO.0000000000001716","article-title":"Combined keratoplasty, pars plana vitrectomy, and flanged intrascleral intraocular lens fixation to restore vision in complex eyes with coexisting anterior and posterior segment problems","volume":"37","author":"Yokogawa","year":"2018","journal-title":"Cornea"},{"key":"2025082803125177000_12.6.e229397.6","first-page":"1","article-title":"Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival","volume":"8","author":"Lee","year":"2014","journal-title":"Clin Ophthalmol"},{"key":"2025082803125177000_12.6.e229397.7","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6701794"},{"key":"2025082803125177000_12.6.e229397.8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.3928\/23258160-20170301-07","article-title":"Wide-Field landers keratoprothesis in various combined corneal and vitreoretinal problems: twelve-month results","volume":"48","author":"Kapran","year":"2017","journal-title":"Ophthalmic Surg Lasers Imaging Retina"},{"key":"2025082803125177000_12.6.e229397.9","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/00003226-199501000-00006","article-title":"Penetrating keratoplasty with vitreoretinal surgery using the Eckardt temporary keratoprosthesis: modified technique allowing use of larger corneal grafts","volume":"14","author":"Gallemore","year":"1995","journal-title":"Cornea"},{"key":"2025082803125177000_12.6.e229397.10","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/00006982-199909000-00010","article-title":"Outcome of vitreoretinal surgery and penetrating keratoplasty using temporary keratoprosthesis","volume":"19","author":"Garcia-Valenzuela","year":"1999","journal-title":"Retina"},{"key":"2025082803125177000_12.6.e229397.11","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1001\/archopht.125.4.552","article-title":"One donor cornea for 3 recipients: a new concept for corneal transplantation surgery","volume":"125","author":"Vajpayee","year":"2007","journal-title":"Arch Ophthalmol"},{"key":"2025082803125177000_12.6.e229397.12","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.clae.2016.10.001","article-title":"Systematic review comparing penetrating keratoplasty and deep anterior lamellar keratoplasty for management of keratoconus","volume":"40","author":"Henein","year":"2017","journal-title":"Cont Lens Anterior Eye"},{"key":"2025082803125177000_12.6.e229397.13","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/00003226-200111000-00026","article-title":"Deep lamellar keratoplasty as surgical management of anterior and posterior segment injuries to the eye","volume":"20","author":"Muraine","year":"2001","journal-title":"Cornea"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:13:02Z","timestamp":1756375982000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":13,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,18]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/bcr-2019-229397"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229397","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}