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Case Reports
. 2021 Jul;118(7):719-723.
doi: 10.1007/s00347-020-01184-5.

[Recurrent DMEK failure]

[Article in German]
C Matar  1 , B Seitz  2 , L Daas  2
Affiliations
Case Reports

[Recurrent DMEK failure]

[Article in German]
C Matar et al. Ophthalmologe. 2021 Jul.

Abstract
in English, German

We report a Patient with Fuchs dystrophy who underwent three Descemet Membrane Endothelial Keratoplasties (DMEK) caused by recurrent graft failure with raise in intraocular pressure and cystoid macular edema. At the third DMEK, herpes was detected in the anterior chamber tap and an adequate therapy was initiated. At the 6 months follow-up the cornea remained clear, visual acuity was 0.8, intraocular pressure was within normal range and macular edema regressed completely. Either a latent Herpes simplex Virus (HSV) infection of the patient was reactivated or an infected donor lamella was transplanted with donor-to-host-to-donor ping-pong transmission.

Wir berichten über einen Fuchs-Endotheldystrophie-Patienten mit drei „Descemet Membrane Endothelial Keratoplasty“ (DMEK) bei rezidierendem Transplantatversagen mit Intraokulardruckerhöhung und cystoides Makulaödem. Bei der dritten DMEK wurde Herpes im Vorderkammeraspirat nachgewiesen und eine adäquate Therapie eingeleitet. Bei der 6 Monaten-Kontrolle blieb die Hornhaut klar, der Visus betrug 0,8, der Intraokulardruck lag im Normbereich und das Makulaödem bildete sich zurück. Entweder wurde eine latente Herpes simplex Virus(HSV)-Infektion des Patienten reaktiviert oder eine befallene Spender-Lamelle transplantiert mit Spender-zu-Wirt-zu-Spender „Ping-Pong“ Übertragung.

Keywords: Cystoid macular edema; Descemet Membrane Endothelial Keratoplasty; Endotheliitis; Graft failure; Herpetic uveitis.

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References

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