First Author: M.Massoumeh IRAN
Co Author(s): H. Hashemi
Purpose:
To describe spontaneous recovery of corneal clarity in one case with central graft detachment after Descemet's stripping endothelial keratoplasty (DSEK).
Setting:
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences
Methods:
In a patient with pseudophakic bullous keratopathy, DSEK was performed through taco-folded technique.
Results:
At examination on first postoperative day and at one week, donor lenticule seemed attached to stroma with persistence of corneal edema. Six weeks later, a clear cornea with near normal central thickness was observed despite large central detachment of contracted graft tissue and distinct space between recipient and transplant. At 3 months postoperatively, transplanted corneal edema, a sheet-like membrane in interface along with extensive iridocorneal adhesion and secondary glaucoma was noted. With presumed diagnosis of epithelial ingrowth the lenticule was removed
Conclusions:
Possible explanations for improvement of corneal edema despite detached graft are incomplete descemetorhexis, an upside down graft with transfer of donor endothelium to recipient bare stroma, seeding of detached donor endothelial cell on recipient stroma and migration of recipient endothelium from remaining rim to bare stroma. Prolonged graft detachment leads to significant areas of bare stroma and predisposes to epithelial ingrowth into the interface. FINANCIAL DISCLOSURE?: No
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