Therapeutic Scleral Lens, Sclerokeratoplasty, and Immunosuppression for Severe Corneal Melt

A 59-year-old male contact lens wearer was admitted to the intensive care unit for COVID-19 pneumonia. As contact lenses were not removed during admission, the patient developed bilateral corneal abscesses, leading to evisceration of the left eye. Complete corneal melting was observed in the right eye, which was preserved with a therapeutic scleral lens filled with moxifloxacin until donor tissue was available for a sclerokeratoplasty combined with amniotic membrane transplantation. In the second procedure consisting of phacoemulsification, capsular bag implantation of the intraocular lens was not possible, and flanged intrascleral fixation was performed. Long-term graft survival has been achieved with systemic and topical immunosuppression.