Abstract

The aim of this study was to describe 2 cases of persistent endothelial graft detachments secondary to corneal gentian violet ink stain marks. This study included a case review of hospital records of 2 eyes with localized Descemet's membrane detachments after Descemet membrane endothelial keratoplasty (DMEK) surgery. Two patients underwent consecutive uncomplicated DMEK surgery for Fuchs endothelial dystrophy with identical techniques. The grafts were marked with an ink marker through a stromal window to ensure correct orientation during donor graft preparation. Both patients had localized detachments around the ink mark on day 1, week 1, and up to 1 month at postoperative review. The persistent detachment was believed to be due to the gentian violet marker used which had a higher concentration of isopropyl alcohol solvent than the standard marking pen routinely used. Ink markers with higher concentrations of isopropyl solvent may result in higher DMEK detachment rates and caution is advised when using these markers.

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