Combined penetrating keratoplasty and pupilloplasty for visual rehabilitation in post-cataract corneal decompensation and scarring

A 56-year-old male presented with severe visual loss following complicated cataract surgery (Best corrected visual acuity [BCVA] best corrected visual acuity 1.8 logMAR [logarithm of the minimum angle of resolution]). Examination showed corneal decompensation with dense stromal scarring and a fixed dilated pupil. The patient underwent combined penetrating keratoplasty, pupilloplasty, and surgical peripheral iridotomy. Postoperatively, the graft remained clear with a well-centered pupil, and BCVA improved to 0.8 logMAR. Simultaneous correction of corneal opacity and pupillary dysfunction can significantly enhance visual rehabilitation in complex post- cataract cases.