Artificial Endothelial Layer Implantation In Chronic Corneal Edema After Failure Of Previous Penetrating Keratoplasty: A Case Report

The purpose of this report is presenting a new artificial corneal implantation technique which may serve as an alternative to lamellar endothelial corneal transplantation and can be used after rejection of a human corneal graft. 

An Endoart® artificial corneal layer was implanted in the University Hospital Antwerp. This device was approved by the US Food and Drug Administration in 2020, our case is the first performed under previous penetrating keratoplasty. 

We implanted an artificial endothelial layer in a patient after rejection of three donor grafts and in an eye with history of chronic inflammation to relieve corneal edema and improve vision. The operation could be performed successfully even though the patient had received a penetrating keratoplasty before. The implant remained well attached for a follow up period of 6 months and corneal edema decreased significantly from 1005 µm to 558 µm.

A new technique to resolve corneal edema by implanting an artificial corneal layer is available and useful to relieve chronic corneal edema in complex cases where conventional techniques are not favorable.