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Successful management of a retained host Descemet's membrane after penetrating keratoplasty (PKP) - A case report.
- Source :
-
International journal of surgery case reports [Int J Surg Case Rep] 2023 Aug; Vol. 109, pp. 108595. Date of Electronic Publication: 2023 Jul 31. - Publication Year :
- 2023
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Abstract
- Introduction and Importance: To report the 21st case showing the rare occurrence of retained Descemet's membrane (DM) following penetrating keratoplasty (PKP). We intend to investigate possible etiologies, expected sequelae, and outcome of neodymium-dpoed yttrium alumnium garnet (Nd: YAG) laser membranectomy.<br />Case Presentation: Our case is a 74-year-old male who underwent PKP surgery in the right eye secondary to corneal decompensation following cataract surgery in addition to corneal thinning secondary to superficial keratectomy related to the pre-existing climatic droplet keratopathy (CDK). Postoperative assessment revealed a retro-corneal membrane within the anterior chamber, which was affecting his vision.<br />Clinical Discussion: Based on the post-operative course and the decreased vision as an indication for intervention, it was decided to excise the retained DM. Membranectomy with Nd: YAG laser was performed, and the patient's visual acuity measurement improved from 20/400 to 20/25. However, the endothelial cell count decreased from 1479 to 520 cells/mm <superscript>2</superscript> (35 % loss) at 15 months post YAG membranectomy with clear graft. Histopathological examination confirmed the clinical suspicion of a retained DM, since it was absent in the submitted host corneal tissue in addition to the pre-existing CDK.<br />Conclusion: Retention of DM following PKP is a rare but possible complication and high index of suspicion is required for proper diagnosis and management to obtain better visual outcome. Nd: YAG laser membranectomy was effective in excising the retained DM and improving vision. Endothelial cell loss following Nd: YAG laser membranectomy as a complication was observed and should be addressed during the treatment plan.<br />Competing Interests: Declaration of competing interest None.<br /> (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 2210-2612
- Volume :
- 109
- Database :
- MEDLINE
- Journal :
- International journal of surgery case reports
- Publication Type :
- Report
- Accession number :
- 37536097
- Full Text :
- https://doi.org/10.1016/j.ijscr.2023.108595