Epithelial ingrowth in descemet membrane endothelial keratoplasty associated with vitreous loss

Epithelial ingrowth is a rare but potentially sight-threatening complication caused by the invasion of corneal or conjunctival epithelial cells into the eye during ocular surgeries. DMEK is emerging as a widely used surgery for endothelial keratoplasty with its improved safety profile. We describe a...

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Bibliographic Details
Published in:BMC ophthalmology 2024-03, Vol.24 (1), p.135-135, Article 135
Main Authors: Cheng, Anny M S, Kubal, Anup, Gupta, Shailesh K, Vedula, Anil S, Yang, David T Y, Kubal, Aarup A
Format: Article
Language:English
Subjects:
Anterior chamber
Brinzolamide
Case Report
Case reports
Cataract
Cataracts
Cornea
Corneal transplantation
Descemet membrane endothelial keratoplasty
Dystrophy
Edema
Endothelium
Epithelial cells
Epithelial ingrowth
Eye surgery
Inflammation
Intraocular lenses
Lasers
Microscopy
Risk factors
Surgery
Vitreous loss
YAG laser
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Summary:Epithelial ingrowth is a rare but potentially sight-threatening complication caused by the invasion of corneal or conjunctival epithelial cells into the eye during ocular surgeries. DMEK is emerging as a widely used surgery for endothelial keratoplasty with its improved safety profile. We describe a case of epithelial ingrowth in the graft-host interface after uneventful DMEK associated with vitreous prolapse in the anterior chamber. An 81-year-old female with Fuchs endothelial dystrophy underwent DMEK for corneal decompensation following cataract surgery. During the DMEK procedure, vitreous prolapse was observed around the intraocular lens (IOL). Her early postoperative course was unremarkable, but a dense paracentral interface opacity was observed during the 3-month follow-up. The area of epithelial ingrowth was imaged with optical coherence tomography (OCT) as a uniform nodule with a discrete increase in interface hyperreflectivity. A low-energy YAG laser was applied to remove the opacity. She maintained good vision and clear cornea without reoccurrence after treatment. We propose that, in addition to the introduction of epithelial cells during surgery, vitreous retention in the anterior chamber may be a risk factor by providing a scaffold that potentially aggravates epithelial ingrowth in DMEK. Our case demonstrated that early YAG intervention may disrupt interface epithelial cell growth, and the transmitted laser energy may fragment the scaffold vitreous noninvasively.
ISSN:1471-2415
1471-2415
DOI:10.1186/s12886-024-03370-4