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Corneal clearance and central endothelial cell repopulation despite graft detachment after Descemet's membrane endothelial keratoplasty

Poster Details

First Author: M.Daravagka GERMANY

Co Author(s):    A. Nestler   P. Wiedemann           

Abstract Details

Purpose:

To report two cases of positive outcome despite graft detachment after DMEK.

Setting:

Retrospective case series.

Methods:

A 81-year-old phakic patient and a 56-year-old pseudophakic patient with the history of Fuchs endothelial dystrophy underwent in 2012, due to symptomatic corneal edema, Triple-DMEK and DMEK respectively. In both patients, a 8 mm diameter corneal graft was inserted into the recipient anterior chamber, positioned onto the posterior stroma and secured by an air filling of the anterior chamber.

Results:

In the postoperative course, both patients presented an almost complete detachment of the graft. However, a spontaneous corneal clearance was observed on both of them. The first patient showed a moderate decrease in the central corneal thickness (from 687μm to 655μm) and increase of the visual acuity (from 2/10 to 4/10) within three months. On the second patient, a 27% decrease of the central corneal thickness (from 799μm to 580μm) was documented after one month. In addition, on both patients, presence of endothelial cells on the posterior stroma despite detached donor tissue was demonstrated by corneal specular microscopy.

Conclusions:

Despite absence of graft attachment after DMEK, endothelial cell regeneration or/and migration may lead to recovery of corneal transparency, improvement of visual acuity and restoration of normal pachymetry and corneal endothelial cell morphology. These observations provide an insight in the physiological mechanisms underlying the outcomes of DMEK. FINANCIAL DISCLOUSRE: NONE

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