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Updated: Apr 25, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Textural interface opacity after Descemet-stripping automated endothelial keratoplasty
Keunsoo Kim1, Brian Alder1, Gargi K Vora1
1From the Gang-nam Seoul Bright Eye Center and Department of Ophthalmology (K. Kim), Korea University College of Medicine, Seoul, South Korea; the Cornea, External Disease, and Refractive Surgery Service (Alder, Vora, Carlson, Kuo, T. Kim), Duke Eye Center, Durham, North Carolina, and the Division of Cornea and Refractive Surgery (Afshari), Shiley Eye Center, San Diego, California, USA.
Interface haze after Descemet-stripping automated endothelial keratoplasty (DSAEK) presents as total or partial textural interface opacity. While most cases improve, some may require repeat DSAEK for persistent visual acuity reduction.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ophthalmic Pathology
Background:
- Interface haze, also termed textural interface opacity, is a potential complication following Descemet-stripping automated endothelial keratoplasty (DSAEK).
- Understanding the characteristics and outcomes of this complication is crucial for managing patients undergoing DSAEK.
Purpose of the Study:
- To describe the clinical presentation, characteristics, and outcomes of interface haze after Descemet-stripping automated endothelial keratoplasty (DSAEK).
Main Methods:
- Retrospective case series analyzing patients who developed interface haze post-DSAEK.
- Review of clinical data, donor information, surgical techniques, histopathology, and anterior segment optical coherence tomography (OCT).
Main Results:
- Interface haze manifested as total (11 cases) or partial (3 cases) textural interface opacity, with onset from 1 day to 7 weeks postoperatively.
- Most patients achieved improved visual acuity (better than 20/50), but 3 required repeat DSAEK due to persistent decreased vision.
- Anterior segment OCT revealed increased hyperreflectivity at the interface; histopathology showed no inflammation or fibrosis in repeat grafts.
Conclusions:
- The etiology of textural interface opacity remains unclear but may involve retained ophthalmic viscosurgical devices (OVD) or their adhesive properties.
- While many cases resolve spontaneously, repeat DSAEK is a viable treatment option for persistent or refractory cases.
