CASE REPORT: RE-DMEK AFTER GRAFT DISLOCATION
Published 2023
- 27th ESCRS Winter Meeting
Reference: CR40
| Type: Case Report (Cornea Day)
| DOI:
10.82333/8ntp-rs79
Authors:
Hüseyin Buğra Türk* 1
, Aysun Şanal Doğan 1
1Department of Ophthalmology,Dışkapı Yıldırım Beyazıt Research and Training Hospital,Ankara,Türkiye
Purpose
It was aimed to share the approach to the patient with free Descemet's membrane graft in the angle region.
Report of case
An 85-year-old female patient, who learned that she had undergone Descemet's membrane endothelial keratoplasty (DMEK) surgery on the right eye 3 months ago, applied with complaints of pain, decreased vision and redness. Visual acuity was at the level of counting fingers at 1 meter. In the anterior segment examination, it was observed that the cornea was edematous and the posterior chamber intraocular lens was centralized. Central corneal thickness was measured as 875 microns by corneal topography (Sirius, Costruzione Strumenti Ophthalmici (CSO), Florence, Italy). Anterior segment optical coherence tomography (OCT) (RTVue-XR, Optovue Inc., Fremont, CA) revealed that the graft was free in the inferior angle region. The patient underwent re-DMEK surgery, the free graft was removed and the newly prepared 7.5 mm Descemet's membrane graft was placed with air. The visual acuity was 0.4 on the postoperative first day, and no complications were observed during and after the surgery. At the sixth month follow-up, it was observed that the best corrected visual acuity was 0.7, the cornea was transparent and the corneal thickness was 584 microns.
Conclusion / Take home message
Graft dislocation can be observed after DMEK surgery and is the cause of surgical failure. Anterior segment OCT is a valuable tool in identifying the presence and location of a dislocated graft and providing useful information in determining appropriate treatment. Primary DMEK-like clinical results can be obtained with re-DMEK surgery performed after failed DMEK due to graft dislocation.