Conjunctiva and cornea: choice of keratoplasty or keratoprosthesis: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Conjunctiva and cornea: choice of keratoplasty or keratoprosthesis

Sample item

A 55-year-old has had three failed penetrating grafts for corneal scarring and now has an opaque, vascularised cornea. Lids, blink and tear film are normal. Which option gives the best chance of visual rehabilitation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Boston type 1 keratoprosthesis

In a vascularised, repeatedly failed graft with a healthy ocular surface, a type 1 keratoprosthesis has a better outcome than another donor graft. Lamellar and endothelial procedures presume a healthy host endothelium or limited depth of disease, and superficial keratectomy treats only surface disease.

Option by option

  • A. Deep anterior lamellar keratoplasty

    Deep anterior lamellar keratoplasty retains host endothelium, which has failed after full-thickness grafts.

  • B. Descemet membrane endothelial keratoplasty

    Endothelial keratoplasty replaces only the endothelium and cannot clear a stromal scar.

  • C. Boston type 1 keratoprosthesis (correct)

    Correct. An artificial cornea suits repeated graft failure when lids and tear film are adequate.

  • D. Superficial keratectomy

    Superficial keratectomy removes only the surface and cannot treat a full-thickness vascular scar.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Boston type 1 keratoprosthesis. In a vascularised, repeatedly failed graft with a healthy ocular surface, a type 1 keratoprosthesis has a better outcome than another donor graft.

Why is "Deep anterior lamellar keratoplasty" not the answer?

Deep anterior lamellar keratoplasty retains host endothelium, which has failed after full-thickness grafts.

Why is "Descemet membrane endothelial keratoplasty" not the answer?

Endothelial keratoplasty replaces only the endothelium and cannot clear a stromal scar.

Why is "Superficial keratectomy" not the answer?

Superficial keratectomy removes only the surface and cannot treat a full-thickness vascular scar.

What concept does this question test?

It tests Conjunctiva and cornea: choice of keratoplasty or keratoprosthesis in Ophthalmology. Lamellar and endothelial procedures presume a healthy host endothelium or limited depth of disease, and superficial keratectomy treats only surface disease.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Conjunctiva and cornea: choice of keratoplasty or keratoprosthesis?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.