TY - JOUR
T1 - Retained host descemet membrane (Auto-DMET) during conversion of deep anterior lamellar keratoplasty to penetrating keratoplasty
T2 - A case report
AU - Vianna, Lucas M.M.
AU - Woreta, Fasika
AU - Kiely, Amanda E.
AU - Jun, Albert S.
PY - 2014/8
Y1 - 2014/8
N2 - PURPOSE:: The aim of this study was to relate a case of deep anterior lamellar keratoplasty (DALK) converted to penetrating keratoplasty in which the host central Descemet membrane (DM) with a large perforation was left attached to the host cornea. METHODS:: This is a case report of a 34-year-old man who underwent an attempted DALK for keratoconus in his left eye, which became complicated with a large rupture in DM during dissection. The host DM was left in place, the donor cornea with DM intact was sutured onto the host bed, and air was injected into the anterior chamber. The patient was monitored by biomicroscopy, pachymetry, topography, anterior segment optical coherence tomography, and specular microscopy. RESULTS:: The postoperative course resulted in improved uncorrected visual acuity, best spectacle-corrected visual acuity, and topography. Corneal edema was observed in the host cornea peripheral to the graft. Three months after the surgery, the endothelial cell density was reduced by 63% compared with the preoperative donor cell density. CONCLUSIONS:: Leaving the host DM during conversion of DALK to penetrating keratoplasty was uneventful in this case, although corneal edema was observed in the area overlying the host cornea. It is possible that the retained DM could provide additional autologous endothelial cells to prolong graft survival.
AB - PURPOSE:: The aim of this study was to relate a case of deep anterior lamellar keratoplasty (DALK) converted to penetrating keratoplasty in which the host central Descemet membrane (DM) with a large perforation was left attached to the host cornea. METHODS:: This is a case report of a 34-year-old man who underwent an attempted DALK for keratoconus in his left eye, which became complicated with a large rupture in DM during dissection. The host DM was left in place, the donor cornea with DM intact was sutured onto the host bed, and air was injected into the anterior chamber. The patient was monitored by biomicroscopy, pachymetry, topography, anterior segment optical coherence tomography, and specular microscopy. RESULTS:: The postoperative course resulted in improved uncorrected visual acuity, best spectacle-corrected visual acuity, and topography. Corneal edema was observed in the host cornea peripheral to the graft. Three months after the surgery, the endothelial cell density was reduced by 63% compared with the preoperative donor cell density. CONCLUSIONS:: Leaving the host DM during conversion of DALK to penetrating keratoplasty was uneventful in this case, although corneal edema was observed in the area overlying the host cornea. It is possible that the retained DM could provide additional autologous endothelial cells to prolong graft survival.
KW - Descemet membrane
KW - cornea
KW - deep anterior lamellar keratoplasty
KW - keratoconus
KW - penetrating keratoplasty
UR - http://www.scopus.com/inward/record.url?scp=84904254475&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904254475&partnerID=8YFLogxK
U2 - 10.1097/ICO.0000000000000162
DO - 10.1097/ICO.0000000000000162
M3 - Article
C2 - 24915019
AN - SCOPUS:84904254475
SN - 0277-3740
VL - 33
SP - 865
EP - 867
JO - Cornea
JF - Cornea
IS - 8
ER -