Histopathological Findings after Descemet's Stripping Automated Endothelial Keratoplasty for the Management of Descemet's Membrane Breaks Secondary to Obstetrical Forceps Injury

Abstract

Case of a 39 y/o male patient that presented due to decreased vision and pain in the left eye secondary to corneal edema related to vertical Descemet's membrane breaks. The patient's past medical history was remarkable for a complicated vaginal delivery with the use of obstetrical forceps and presumed obstetrical forceps corneal injury. Herein, we demonstrate for the first time the use of descemet's stripping automated endothelial keratoplasty (DSAEK) in the management of this complication and for the first time show histologically the area of prior descemet's membrane break in the submitted stripped descemet's membrane.

Figure 1

Slit lamp photo showing corneal edema and vertical opaque lines at the level of Descemet's membrane.

Figure 2

Slit lamp biomicroscopy photo at 1.5 years after DSAEK showing a nonedematous cornea with minimal superficial scarring.

Figure 3

Histopathology of the stripped Descemet's membrane demonstrating an area of nodular thickening of Descemet's membrane composed of concentric scrolls of PAS-positive material (periodic acid-schiff stain, original magnification x400).