Posters

Persistence of receiver Descemet's membrane and endothelium after penetrating keratoplasty: two case series

Poster Details

First Author: L.Tabuenca Del Barrio SPAIN

Co Author(s): M. Mozo Cuadrado   O. Iturralde Errea                 

Abstract Details

Purpose:

To show the persistence of the receiver Descemet membrane and endothelium as an infrequent complication after penetrating keratoplasty.To present two clinical cases with persistent receptor endothelium after penetrating keratoplasty showing biomicroscopy examination and anterior segment optical coherence tomography (AS-OCT)  images.

Setting:

Servicio oftalmología. Complejo Hospitalario de Navarra, Pamplona, España.

Methods:

1. A 88 year-old male presented with pain in his right eye due to a bullous keratopathy. A penetrating keratoplasty was performed. A translucent membrane was founded behind donor graft. AS-OCT images confirmed the persistence of the receiver Descemet and endothelium. It became opaque decreasing visual acuity so a YAG endotheliotomy was necessary. 2. A 83 year-old female presented with corneal edema and fibrosis after cataract surgery due to Fuchs' endothelial dystrophy. A penetrating keratoplasty was performed and a little paracentral translucent membrane was revealed behind donor graft. AS-OCT confirmed it. Visual acuity didn´t decrease, so observation was recommended.

Results:

There are persistence of the receiver Descemet membrane and endothelium in both clinical cases after penetrating keratoplasties due to advanced bullous keratopathy. Over time, these membranes might be opacified causing a decrease in visual acuity. An adequate following up is necessary because if the membranes become opaque, a treatment is required. YAG endotheliotomy is  the first step for the treatment of this pathology. Surgery treatment is reserved for both endothelium contact, monocular diplopia or refractories ocular hypertension patients.

Conclusions:

The permanence of the receiver endothelium is very infrequent after performing penetrating keratoplasty. There is little literature about it and unnoticed viscodissection during surgery is proposed as main cause in advanced bullous keratopathy cases.  The trepanning of the cornea must be very meticulous to avoid future complications.

Financial Disclosure:

None