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Related Experiment Videos

Inadvertent corneal button inversion during penetrating keratoplasty.

S Ohlrich1, L W Hirst, M Harrison

  • 1Department of Surgery, University of Queensland, Princess Alexandra Hospital, Woolloongabba, Australia.

Cornea
|November 1, 1992
PubMed
Summary

Corneal transplantation complications can arise from inadvertent donor button inversion, leading to inflammation. Early diagnosis via biopsy and repeat surgery can restore graft clarity, explaining some graft failures.

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Area of Science:

  • Ophthalmology
  • Transplantation Surgery
  • Histopathology

Background:

  • Pseudophakic bullous keratopathy is a common indication for corneal transplantation.
  • Corneal graft inversion is a rare but significant operative complication.
  • Intraocular inflammation can occur following corneal transplantation.

Observation:

  • A case of inadvertent corneal button inversion during transplantation for pseudophakic bullous keratopathy is presented.
  • The inverted graft initially showed intense intraocular inflammation.
  • Diagnosis was confirmed by superficial corneal biopsy of Descemet's membrane.

Findings:

  • Histological examination revealed persistent donor epithelium on the inverted button.
  • No residual endothelium was found on the externalized surface of the inverted graft.

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  • Laboratory attempts confirmed the difficulty in replicating corneal graft inversion.

    • Implications:

    • This complication may explain unexpected primary corneal graft failures in the literature.
    • Prompt diagnosis and surgical intervention (repeat transplantation) can lead to successful outcomes.
    • Understanding graft inversion is crucial for improving corneal transplantation techniques and patient outcomes.