Spontaneous Corneal Clearance Despite Dislocated Graft after Descemet s Stripping Automated Endothelial Keratoplasty

ABSTRACT

Corneal transplantation is a widely practiced surgical procedure. Over the past decade, lamellar techniques have been developed to replace penetrating keratoplasty (PK). Endothelial Keratoplasty (EK) combines fast visual rehabilitation and low risk profile and has therefore replaced penetrating keratoplasty in the treatment of corneal endothelial diseases such as endothelial dystrophies (Fuchs’ endothelial dystrophy, congenital hereditary endothelial dystrophy, posterior polymorphous dystrophy), pseudophakic and aphakic bullous keratopathy, endothelial decompensation caused by intraocular surgery, trauma or glaucoma drainage devices, iridocorneal endothelial (ICE) syndrome and endothelial failure post penetrating keratoplasty.1,2,3The concept of EK is based on the creation of a (nearly) normal corneal anatomy by positioning a donor disc comprising endothelium and Descemet Membrane (DM) (DM endothelial keratoplasty, DMEK) or endothelium, DM and posterior stroma (Descemet stripping automated endothelial keratoplasty, DSAEK) onto the back surface of the recipient cornea.4 Graft detachment or dislocation is a major cause of complication following EK procedures. Rarely the recipient cornea may clear within several weeks to months after EK despite the presence of a detached or dislocated graft.5,6,7,8,9,10,11 The exact mechanism of spontaneous corneal clearance remains unknown.In the present report, we describe a case of spontaneous corneal clearance despite dislocated graft into posterior chamber without replacement of the graft after DSAEK.