Abstract
BackgroundWe report the first histopathologically proven occurrence of a retrocorneal membrane after Descemet’s membrane endothelial keratoplasty.Case presentationA white Caucasian 76-year-old woman received penetrating keratoplasty on her right eye 2 years after Descemet’s membrane endothelial keratoplasty surgery with combined cataract extraction and intraocular lens implantation for Fuchs’ endothelial corneal dystrophy due to an allograft rejection with ensuing graft failure.Her preoperative vision was counting fingers (20/2000) caused by immunological debris, corneal edema, and secondary membrane formation. Her postoperative vision at 3 months was 20/125.The histopathological evaluation showed a membranous structure overlying the denuded Descemet membrane.ConclusionsWe report a case of a histopathologically proven retrocorneal membrane after Descemet’s membrane endothelial keratoplasty surgery.
Highlights
Descemet’s membrane endothelial keratoplasty (DMEK) is a method to transplant donor corneal endothelium with its adjacent Descemet’s membrane (DM) to replace respective diseased recipient tissues [1, 2]
It is well known that these structures can penetrate keratoplasty and it is not a novelty in itself [8]
The retrocorneal membrane after DMEK in this case was of the non-regenerative fibrotic type with contractile aspects
Summary
Descemet’s membrane endothelial keratoplasty (DMEK) is a method to transplant donor corneal endothelium with its adjacent Descemet’s membrane (DM) to replace respective diseased recipient tissues [1, 2]. A standard postoperative regimen was followed (moxifloxacin eye drops four times a day for 2 weeks and prednisolone eye drops four times a day with slow tapering) Her postoperative visual acuity was 20/ 50 with significant subjective improvement (uncorrected with persistent stromal haze). The histopathological report stated an endothelial insufficiency secondary to a retrocorneal fibrous membrane and deep neovascularizations secondary to an allograft rejection (Fig. 2). From the posterior stroma a thin membrane of connective tissue/corneal stroma had grown on the back of the lamellar graft This membrane continued to the right so that more than 50% of the graft was covered, eventually leading to endothelial decompensation. On histological examination, it was an “ordinary retrocorneal membrane,” as is often observed after penetrating keratoplasty. After DMEK, such a membrane has not previously been described histologically (Fig. 3)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
