Donor Descemet Membrane Detachment After Endothelial Keratoplasty

Romaniv, Natalya; Price, Marianne O.; Price, Francis W.; Mamalis, Nick

doi:10.1097/01.ico.0000243950.99472.f5

Cited by 29 publications

(14 citation statements)

References 13 publications

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“…The adherence of lamellar grafts to the residual DM suggests that the DM may not need to be removed in cases without optical impurities at the level of the DM. This conclusion agrees with the histopathologic observations of Romaniv et al, 5 who noted that the anterior stromal surface of a lamellar graft was well opposed to the previous PK endothelium (the DM was not removed before lamellar graft placement). Price and Price 11 subsequently have published 5 cases of EK status after failed PK in which the DM was not removed before endothelial graft placement.…”

Section: Discussionsupporting

confidence: 91%

“…10 However, although histologically inconspicuous, the interface was discernible, if only because of the noticeable difference between the host and donor graft stromal lamellar patterns. The finding of an inconspicuous interface is consistent with that of Romaniv et al, 5 who described a hypocellular primitive stromal scar in a patient undergoing EK for failed PK. This finding is also consistent with that of Lord et al, 6 who performed PK after successful EK secondary to subsequent herpetic epithelial and stromal keratitis.…”

Section: Discussionsupporting

confidence: 86%

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Histopathology of Posterior Lamellar Endothelial Keratoplasty Graft Failure

Sbarbaro¹,

Eagle²,

Thumma³

et al. 2008

Cornea

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Histopathology suggests endothelial decompensation, incomplete graft adherence, and the formation of retrocorneal fibrous membranes as possible etiologies for EK failure. The adherence of endothelial grafts to residual host DM suggests that it may not be necessary to remove optically clear DM before endothelial graft placement. The inconspicuous nature of the EK interface suggests that it may not play a large role in image degradation, although more study is needed.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 86%

Histopathology of Posterior Lamellar Endothelial Keratoplasty Graft Failure

Sbarbaro¹,

Eagle²,

Thumma³

et al. 2008

Cornea

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“…Histology of the EK-PK interface in our case did not exhibit any proliferation or hypercellular scarring, which makes it similar to the healing of laser in situ keratomileusis [25] . This has already been shown in a case of endothelial graft failure caused by donor Descemet's membrane detachment [26] . Ultrastructural findings in our case might offer further evidence against scar formation in cases of EK.…”

Section: Discussionmentioning

confidence: 83%

Endothelial Keratoplasty without Descemet’s Membrane Stripping: Histologic and Ultrastructural Findings

et al. 2009

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Aim: To report histologic and ultrastructural findings of endothelial keratoplasty (EK) performed without Descemet’s membrane stripping. Methods: Clinical techniques, histology, and transmission electron microscopy. Results: A 55-year-old woman was referred to us, after 2 unsuccessful penetrating keratoplasties (PKs), for pseudophakic bullous keratopathy. An 8.0-mm EK without Descemet’s membrane stripping was performed, and clarity was restored to the failed penetrating regraft. A year later, the lamellar graft failed, and a third PK was performed for intractable corneal edema. Light microscopy of a semi-thin section of the trephined corneal button showed both the recipient’s and the donor’s Descemet’s membrane, the well-preserved structure of the full-thickness graft, and marked edema of the adherent stromal carrier of the endothelial transplant. The host endothelium was absent at the interface, and the donor endothelium was atrophic. Electron microscopy revealed regularity and even spacing of collagen fibrils as well as quiet keratocytes on both sides of Descemet’s membrane at PK-EK interface. Conclusion: These findings suggest a lack of proliferation and hypercellular scarring, and offer further support to the already proven merits of EK.

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“…Previous procedures in the eye included tube shunt placement, PKP, and cataract surgery with posterior chamber intraocular lens implantation. 12 A detachment of the Descemet membrane resulted in primary graft failure and the need for repeat PKP. To our knowledge, there are no reports of successful DSEK after Ophtec 311 iris reconstruction lens implantation.…”

mentioning

confidence: 98%

Descemet Stripping Endothelial Keratoplasty After Ophtec 311 Iris Reconstruction Lens Implantation

Aldave

Baghdasaryan

Miller

2011

Cornea

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DSEK can be successfully performed in eyes with partial or complete aniridia, such as those after Ophtec iris reconstruction lens implantation. Modifications to the standard DSEK technique increase the probability of successful donor adherence and decrease the risk of posterior dislocation of the donor corneal button. However, endothelial rejection may occur at an increased frequency, resulting in secondary graft failure.

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Donor Descemet Membrane Detachment After Endothelial Keratoplasty

Abstract: The EK graft was well apposed with apparent good adherence to the recipient's prior failed PK, and early endothelial failure was attributable to partial Descemet membrane detachment.

Cited by 29 publications

References 13 publications

Histopathology of Posterior Lamellar Endothelial Keratoplasty Graft Failure

Histopathology of Posterior Lamellar Endothelial Keratoplasty Graft Failure

Endothelial Keratoplasty without Descemet’s Membrane Stripping: Histologic and Ultrastructural Findings

Descemet Stripping Endothelial Keratoplasty After Ophtec 311 Iris Reconstruction Lens Implantation

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