Epithelial Ingrowth After Descemet Membrane Endothelial Keratoplasty

Cornea. 2019 Sep;38(9):1189-1191. doi: 10.1097/ICO.0000000000001964.

Abstract

Purpose: To report the diagnosis, histological findings, and treatment of a patient who developed epithelial ingrowth after Descemet membrane endothelial keratoplasty (DMEK).

Methods: We present the case of a type 2 diabetic 60-year-old man who underwent DMEK for Fuchs dystrophy. Two months after surgery, an epithelial ingrowth in the graft-host interface was suspected. After a 3-month follow-up period in which progressive and centrifugal growth of the epithelial cells in the interface was documented, penetrating keratoplasty (PK) was performed to remove all areas of epithelial ingrowth. No evidence of recurrence was observed 1 year later.

Results: Histopathologic evaluation of the corneal button obtained in the PK procedure confirmed the epithelial ingrowth in the interface between the Descemet membrane graft and the host cornea.

Conclusions: Epithelial ingrowth may occur after a corneal endothelium transplant. There have been multiple reports of epithelial ingrowth after Descemet stripping automated endothelial keratoplasty, but this particular case report suggests that epithelial ingrowth may also occur after DMEK. In this case, PK solved the complication.

Publication types

  • Case Reports

MeSH terms

  • Corneal Diseases / etiology*
  • Descemet Stripping Endothelial Keratoplasty / adverse effects*
  • Endothelium, Corneal / pathology*
  • Endothelium, Corneal / transplantation
  • Fuchs' Endothelial Dystrophy / surgery*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*