Cornea

Skip Navigation LinksHome > December 2013 - Volume 32 - Issue 12 > 5-Fluorouracil for Epithelial Downgrowth After Descemet Stri...
Cornea:
doi: 10.1097/ICO.0b013e3182a9fc85
Case Report

5-Fluorouracil for Epithelial Downgrowth After Descemet Stripping Automated Endothelial Keratoplasty

Wong, Ryan K. MD*; Greene, Daniel P. MD*; Shield, David R. MD*; Eberhart, Charles G. MD, PhD; Huang, John J. MD*; Shayegani, Aryan MD*

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Abstract

Purpose: To report the use of intracameral 5-fluorouracil (5-FU) to treat epithelial downgrowth after performing a Descemet-stripping automated endothelial keratoplasty (DSAEK).

Methods: We describe the case of a 79-year-old woman who underwent a DSAEK for pseudophakic Fuchs endothelial corneal dystrophy. The patient required 2 repeat DSAEKs for graft failure and persistent, visually significant interface haze. Six months after the third and most recent DSAEK, the patient was followed up and found to have a visual acuity of 20/100. On examination, the patient continued to have a persistent interface haze. However, the patient also had a cellular anterior chamber reaction despite the administration of frequent topical corticosteroids, and subtle findings of a translucent, membranous growth over the iris. Argon laser photocoagulation of the area resulted in a whitening response, characteristic of epithelial growth.

Results: Epithelial downgrowth was diagnosed, and intracameral 5-FU was administered. One month after the injection was given, the patient's examination results and vision improved to 20/60. Six months after the single injection, the patient had a clear DSAEK graft without interface haze, a quiet chamber, and 20/30 visual acuity.

Conclusions: Epithelial downgrowth that occurs after performing a DSAEK can be treated successfully using intracameral 5-FU.

© 2013 by Lippincott Williams & Wilkins.

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