Spontaneous Corneal Clearance in the Presence of a Partially Detached Graft after Non-Descemet Stripping Automated Endothelial Keratoplasty

Konstantinos Droutsas; Apostolos Lazaridis; Chrysanthi Koutsandrea; Klio I Chatzistefanou; Marilita M Moschos; Walter Sekundo

doi:10.1159/000443632

Spontaneous Corneal Clearance in the Presence of a Partially Detached Graft after Non-Descemet Stripping Automated Endothelial Keratoplasty

Case Rep Ophthalmol. 2016 May 24;7(2):321-7. doi: 10.1159/000443632. eCollection 2016 May-Aug.

Authors

Konstantinos Droutsas¹, Apostolos Lazaridis², Chrysanthi Koutsandrea³, Klio I Chatzistefanou³, Marilita M Moschos³, Walter Sekundo⁴

Affiliations

¹ Department of Ophthalmology, Philipps University, Marburg, Germany; The Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; First Department of Ophthalmology, National and Kapodistrian University of Athens, Medical School of Athens, Athens, Greece.
² Department of Ophthalmology, Philipps University, Marburg, Germany; First Department of Ophthalmology, National and Kapodistrian University of Athens, Medical School of Athens, Athens, Greece.
³ First Department of Ophthalmology, National and Kapodistrian University of Athens, Medical School of Athens, Athens, Greece.
⁴ Department of Ophthalmology, Philipps University, Marburg, Germany.

Abstract

Purpose: To report the explantation of a detached and opaque donor disc as an alternative to secondary keratoplasty in a case of persistent graft detachment followed by spontaneous clearance of the recipient cornea after non-Descemet stripping automated endothelial keratoplasty (non-DSAEK).

Results: Four months after graft explantation, BSCVA was 0.5 and endothelial cell density (ECD) was 1,221 cells/m(2). After 13 months, BSCVA was still 0.6 while ECD had fell to 800, and 2 years later, the endothelium decompensated. BSCVA was 0.3 and ECD was not measurable.

Conclusions: To our knowledge this is the first report of explantation of an endothelial graft as an alternative to re-keratoplasty in a case of spontaneous corneal clearance. This minimally invasive treatment may be considered in similar cases. However, due to the ongoing loss of endothelial cells after endothelial keratoplasty, a re-keratoplasty may still be needed in the long term.

Keywords: Contact inhibition; Non-Descemet stripping automated endothelial keratoplasty; Spontaneous corneal clearance.

Publication types

Case Reports