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E. Furusato, A. A. Hidayat; Descemet’s Stripping With Endothelial Keratoplasty: A Light Microscopic Study of 10 Cases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1937.
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To describe histopathologically 10 corneal specimens of Descemet’s stripping endothelial keratoplasty (DSEK) and to assess possible causes for failed grafts in two patients.
Descemet’s membrane and corneal endothelium from 8 patients with Fuchs’endothelial corneal dystrophy (FECD) and 2 with pseudophakic bullous keratopathy were studied by light microscopy. Additionally, corneal buttons from failed grafts in two patients following DSEK were also evaluated. Formalin fixed tissues were stained with hematoxylin-eosin and periodic acid-Schiff stains.
There was partial loss of the atrophic endothelial cells in all cases. In patients with FECD, Descemet’s membrane was also thickened, multilaminated and exhibited excrescences. The failed graft in one person showed marked loss of the atrophic endothelium and stromal edema, consistent with iatrogenic failure. The failed graft in the other patient disclosed incomplete stripping of Descemet’s membrane and dislocation of thickened donor’s Descemet’s membrane.
1. DSEK provides adequate tissue for histopathologic evaluation.2. Iatrogenic graft failure may occur following DSEK as was seen in one patient.3. Incomplete stripping of Descemet’s membrane in the other patient, probably prevented donor adhesion to the recipient cornea and caused donor dislocation.
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