Purpose: To report a case of progressive fibrotic contraction of the posterior lamellar graft after initially successful Descemet's stripping automated endothelial keratoplasty (DSAEK).
Methods: Retrospective report of clinical data and histopathological analysis of excised corneal tissue.
Results: A 63-year-old woman underwent uncomplicated DSAEK in her left eye due to endothelial dystrophy. During the first months after surgery, her visual acuity was 0.3, and a semilunar contraction gradually appeared at the edge of the graft. Over the following months, the fibrotic changes progressed and visual acuity decreased, with no improvement after uncomplicated cataract surgery. A successful penetrating keratoplasty was performed, and the excised corneal button with an attached posterior lamellar graft was histologically examined. The affected part of the graft consisted of a thickened fibrocellular tissue positive for glycosaminoglycans and smooth muscle actin.
Conclusions: The present case demonstrates asymmetric fibrotic contraction of a DSAEK graft.
Keywords: Anti-smooth muscle actin; Cornea; Endothelial keratoplasty; Transplantation.