Double Descemet’S Membrane In Donor Corneal Grafts With Fuchs Endothelial Dystrophy

Published 2022 - 40th Congress of the ESCRS

Reference: PO035 | Type: Case report | DOI: 10.82333/40vh-vy24

Authors: Marta Garrido Marín* ¹ , Julia Angrill Valls ¹ , David Aragón Roca ¹ , Monica Bergés Martí ² , Laura Sánchez Vela ¹ , Alejandro Pardo Aranda ¹ , Rafael Fischer Fernandez ¹ , Laia Bisbe Lopez ¹

¹Ophthalmology,Hospital Universitari Vall d'Hebron,Barcelona,Spain, ²Ophthalmology,Hospital de Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral,Sant Joan Despí,Spain

In 10% of Fuchs Endothelial Dystrophy (FED) patients, a lamellar split in Descemet’s membrane or a "double Descemet’s" has been described, even without having a clear cornea guttata, the classic sign of this entity. Patients with long-standing corneal edema tend to have thinner than normal corneas after Descemet’s Membrane Endothelial Keratoplasty (DMEK) because of the stromal fibrosis that it implies. We present three cases with post-DMEK corneal thicknesses around 600 microns and normal endothelial counts. This could be explained by the existence of a possible degree of FED in the donor tissue, objectified by the presence of a double Descemet’s membrane assessed by High Resolution Anterior Segment Optical Coherence Tomography (HR-AS-OCT).

Hospital Universitari Vall d’Hebron, Barcelona, Spain

Surgical videos and images of anterior segment, topographies and AS-OCT are presented, in which a double Descemet’s membrane is observed in three patients after a DMEK procedure. In these cases, a possible FED is suspected in the donor graft.

It is important to recognize FED cases in donor grafts prior to lamellar corneal transplant surgery, because there is a possible worse functionality of these grafts once implanted. Surgeons should work together with Tissue Banks to help them recognise better mild FED cases or in order to improve detection of mild FED cases.