Le, Viet Nhat Hung ORCID: 0000-0001-9864-782X, Wabnig, Florian, Bachmann, Bjoern and Cursiefen, Claus . Epithelial downgrowth after Descemet membrane endothelial keratoplasty. Eur. J. Ophthalmol.. LONDON: SAGE PUBLICATIONS LTD. ISSN 1724-6016

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Abstract

Purpose: To describe a patient with epithelial downgrowth after Descemet membrane endothelial keratoplasty. Methods: Case report. Results: A 73-year-old woman underwent triple Descemet stripping automated endothelial keratoplasty for cataract and corneal edema secondary to Fuchs endothelial dystrophy in the left eye elsewhere. Three years later, Descemet membrane endothelial keratoplasty was performed at our department due to graft failure. One month after the operation, her vision improved to 20/32 and maintained stable. At the 14-month visit, her visual acuity decreased, and a routine examination revealed epithelial downgrowth at the posterior surface of the cornea and partly beneath the graft, accompanied by presumed graft rejection. Therefore, repeat Descemet membrane endothelial keratoplasty with epithelial scraping and intracameral injection of 5-fluorouracil was indicated. She recovered 20/25 vision by 1 month after the surgery. However, small sheet-like epithelial downgrowth recurred 1 month later. The epithelial downgrowth was limited to the peripheral margin of the Descemet membrane endothelial keratoplasty graft and did not affect the visual axis. Epithelial downgrowth showed islands with connection between epithelial downgrowth and clear corneal incision on anterior segment optical coherence tomography images. Histopathologic evaluation of the removed Descemet membrane endothelial keratoplasty graft confirmed conjunctival epithelium as the source. Under close observation at the current 4-year follow-up, the epithelial downgrowth remained stable and localized and her vision increased to 20/20. Conclusion: Epithelial downgrowth can occur after Descemet membrane endothelial keratoplasty. The limited progression of epithelial downgrowth in this patient suggests that this condition after Descemet membrane endothelial keratoplasty even in the recurrence stage may cause less damage than expected and may only need to be observed closely if no progression occurs.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Le, Viet Nhat HungUNSPECIFIEDorcid.org/0000-0001-9864-782XUNSPECIFIED
Wabnig, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bachmann, BjoernUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cursiefen, ClausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-341128
DOI: 10.1177/1120672120912413
Journal or Publication Title: Eur. J. Ophthalmol.
Publisher: SAGE PUBLICATIONS LTD
Place of Publication: LONDON
ISSN: 1724-6016
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CLINICAL-COURSE; BLOCK EXCISION; INGROWTH; CORNEAMultiple languages
OphthalmologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34112

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