Abstract：
PURPOSE:To report a series of dislocations of the donor graft into the posterior segment associated with Descemet stripping endothelial keratoplasty (DSAEK) and to identify possible risk factors for dislocation and clinical outcomes. DESIGN:Retrospective case series. METHODS:Cases of donor graft dislocation into the posterior segment associated with endothelial keratoplasty were identified from the clinical experience of 7 surgeons. Observations included the preoperative surgical history of each eye, preoperative and postoperative visual acuity, management of the complication, and the postoperative clinical course. No identified cases were excluded from this series. RESULTS:Eight posterior graft dislocations were associated with DSAEK surgery. Each eye had a history of vitrectomy. Five eyes had sutured posterior chamber intraocular lenses, 1 eye had a sulcus intraocular lens, and 2 eyes were aphakic. Each eye required repeat grafting, and in 6 of 8 eyes, pars plana vitrectomy was used to remove the dislocated graft. Final visual acuities ranged from 20/30 to no light perception. CONCLUSIONS:Graft dislocation into the posterior segment is a rare complication of DSAEK surgery that can lead to permanent vision loss. It has occurred in eyes that have undergone previous vitrectomy and complicated intraocular lens placement or were aphakic. As is the case with a dropped lens nucleus during cataract extraction, visual acuities after a dropped DSAEK graft range from very good to no light perception. Better postoperative results seem to be associated with prompt removal of the posteriorly dislocated graft.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Afshari NA,Gorovoy MS,Yoo SH,Kim T,Carlson AN,Rosenwasser GO,Griffin NB,McCuen BW 2nd,Toth CA,Price FW Jr,Price M,Fernandez MMdoi
10.1016/j.ajo.2011.09.006subject
Has Abstractpub_date
2012-04-01 00:00:00pages
638-42, 642.e1-2issue
4eissn
0002-9394issn
1879-1891pii
S0002-9394(11)00687-8journal_volume
153pub_type
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