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Case Reports
. 2024 Oct 24;15(1):736-741.
doi: 10.1159/000541644. eCollection 2024 Jan-Dec.

Visual Recovery and Endothelial Repopulation after DMEK Graft Removal and Vitrectomy for Late Endophthalmitis: A Case Report

Eszter Szalai  1 , Michael W Belin  2 , Zsuzsanna Szijártó  1 , Adrienne Csutak  1
Affiliations
Case Reports

Visual Recovery and Endothelial Repopulation after DMEK Graft Removal and Vitrectomy for Late Endophthalmitis: A Case Report

Eszter Szalai et al. Case Rep Ophthalmol. .

Abstract

Introduction: The aim of the study was to report a unique case with excellent clinical outcomes after late endophthalmitis following Descemet's membrane endothelial keratoplasty (DMEK) surgery requiring donor graft removal without replacement.

Case presentation: A 67-year-old female with a prior ocular history of bilateral cataract surgery, Fuchs endothelial dystrophy, and pseudophakic DMEK in the left eye presented with endophthalmitis 2 months after keratoplasty. DMEK graft removal without replacement with an intracameral washout, pars plana vitrectomy, intracameral, and intravitreal antibiotics resulted in an excellent visual outcome (20/25).

Conclusion: This is a unique case of late endophthalmitis following DMEK surgery requiring graft removal and pars plana vitrectomy with excellent visual recovery without donor replacement.

Keywords: DMEK; Endophthalmitis; Endothelium.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Fig. 1.
Fig. 1.
Clinical findings of the left eye 2 months after DMEK. a Anterior segment photo showing semitransparent cornea and hypopyon (yellow arrow). b Swept-source OCT of the thickened cornea with the rolled DMEK graft containing hyperreflective conglomerate and anterior chamber flare. c B scan ultrasound of the left eye with moderate vitreous opacities and attached retina.
Fig. 2.
Fig. 2.
Clinical findings of the left eye 8 months after DMEK graft removal and vitrectomy. a Anterior segment photo of the left eye showing transparent cornea and normal anterior chamber. b Swept-source OCT of the left cornea demonstrating normal pachymetry. c In vivo confocal microscopy photo of the central endothelial cells with polymegathism and pleomorphism.
See this image and copyright information in PMC

References

    1. Borkar DS, Wibbelsman TD, Buch PM, Rapuano SB, Obeid A, Ho AC, et al. . Endophthalmitis rates and clinical outcomes following penetrating and endothelial keratoplasty. Am J Ophthalmol. 2019;205:82–90. - PubMed
    1. Moshirfar M, Webster CR, Seitz TS, Ronquillo YC, Hoopes PC. Ocular features and clinical approach to cataract and corneal refractive surgery in patients with myotonic dystrophy. Clin Ophthalmol. 2022;16:2837–42. - PMC - PubMed
    1. Mootha VV, Hansen B, Rong Z, Mammen PP, Zhou Z, Xing C, et al. . Fuchs’ endothelial corneal dystrophy and RNA foci in patients with myotonic dystrophy. Invest Ophthalmol Vis Sci. 2017;58(11):4579–85. - PMC - PubMed
    1. Mootha VV, Hussain I, Cunnusamy K, Graham E, Gong X, Neelam S, et al. . TCF4 triplet repeat expansion and nuclear RNA foci in Fuchs’ endothelial corneal dystrophy. Invest Ophthalmol Vis Sci. 2015;56(3):2003–11. - PMC - PubMed
    1. Kim P, Amiran MD, Lichtinger A, Yeung SN, Slomovic AR, Rootman DS. Outcomes of descemet stripping automated endothelial keratoplasty in patients with previous glaucoma drainage device insertion. Cornea. 2012;31(2):172–5. - PubMed

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