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Cornea:
doi: 10.1097/ICO.0000000000000195
Case Report

Progressive Corneal Clearance After a DMEK Graft Partially Folded Over on Itself in a Non-Fuchs Pseudophakic Eye

Ponce de los Ríos, Celso D. MD; Gris, Óscar MD, PhD; Elies, Daniel MD; Güell, Jose L. MD, PhD

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Abstract

Purpose:

The aim of this study was to report progressive corneal clearance and endothelial cell repopulation after a Descemet membrane endothelial keratoplasty graft that was partially folded over on itself in a pseudophakic patient without endothelial dystrophy.

Methods:

Retrospective case report.

Results:

A 75-year-old man without Fuchs dystrophy underwent cataract extraction on his right eye in 2007, and 5 years later, Descemet membrane endothelial keratoplasty was performed for pseudophakic edema in the same eye at another center. On presentation at our institution, a graft that is partially folded over on itself was observed in the right eye, leaving about 2/3 of donor endothelium correctly exposed. The graft was only attached in the lower part of the cornea. We observed progressive clearance of the entire cornea within 7 months with reendothelialization of the entire cornea. Good visual acuity was achieved, with no evidence of recurrent corneal edema.

Conclusions:

Endothelial cell migration and repopulation in the presence of a folded attached endothelium graft may occur, resulting in corneal clearance and improved visual outcome. This could happen in patients with pseudophakic edema without congenital endothelial dystrophy.

Copyright © 2014 by Lippincott Williams & Wilkins

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