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First Author: H.Hsu TAIWAN
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To report a rare case postoperative graft dislocation after descemet stripping automated endothelial keratoplasty (DSAEK) in a pseudophakic eye.
The 76-year-old man, who underwent the complicated cataract surgery of the right eye with ruptured posterior capsule, received DSAEK for pseudophakic bullous keratopathy. Initially, DSAEK was performed smoothly; however, donor graft was not perceived postoperatively. Indirect ophthalmoscopy revealed posterior graft dislocation in inferior side of the fundus. The dislocated graft was removed by 23-gauge pars plana vitrectomy and penetrating keratoplasty was performed simultaneously for persistent bullous keratopathy.
Postoperatively, rapid clearing of the donor and recipient cornea was noted. Unfortunately, subsequent retinal detachment was found during 3 months follow up. He underwent 20-gauge pars plana vitrectomy and silicone oil tamponade. The patient was closely followed for 12 months and showed mild improvement in visual acuity.
Graft dislocation into the posterior segment is a rare complication of DSAEK surgery. It has occurred in eyes that have undergone previous vitrectomy and complicated intraocular lens placement. Better postoperative results seem to be associated with prompt removal of the posteriorly dislocated graft.