Histopathologic Features of Descemet Membrane Endothelial Keratoplasty Graft Remnants, Folds, and Detachments.

Host Descemet’s membrane remnants can be a problem after DMEK

An analysis of post-mortem corneas of eyes that had undergone Descemet’s membrane endothelial keratoplasty (DMEK) indicates that incomplete removal of the host DM is common after the non-penetrating procedure and that the complication can result in postoperative DMEK graft detachment and wound instability with the potential for scarring. The study’s authors examined, under light microscopy, 11 post-mortem DMEK corneas of eight patients who had undergone DMEK for Fuchs endothelial dystrophy. They found that although nine corneas had normal anatomic features in the corneal centre, 10 corneas showed specific abnormalities in the periphery, including nine where the host remnants overlapped the grafted membrane, which in three cases caused scarring.