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Updated: Apr 21, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Management of posteriorly dislocated endothelial keratoplasty donor lenticule
Mark R Barakat1, Reecha Sachdeva, Ricardo N Sepulveda
1From the *Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; †Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio; ‡Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio; and §Department of Transplant, Cleveland Clinic, Cleveland, Ohio.
Purpose:
The purpose of this study was to describe the management of a keratoplasty lenticule adhering to the retina after intraoperative dislocation.
Methods:
We describe the posterior dislocation of the donor lenticule during endothelial keratoplasty in a 72-year-old woman with a transscleraly sutured intraocular lens, previous pars plana vitrectomy, and a posteriorly positioned Ahmed glaucoma tube shunt. The lenticule was retrieved through a pars plana approach 2 weeks later, at which time it was tightly adherent to the extramacular retina. Concurrent keratoplasty was performed.
Results:
Six months after retrieval of the dislocated lenticule with repeat keratoplasty, the retinal examination is stable and the new graft remains attached.
Conclusion:
An iris defect, the absence of capsular support, and a history of previous vitrectomy are all potential risk factors for the intraoperative migration of a keratoplasty lenticule. The surgical view 2 weeks after dislocation was not a limiting factor in the retrieval of the lenticule. However, the tight adherence of the lenticule to the retina required extensive peeling. To avoid a more difficult surgical repair and the potential for scar formation, earlier surgical repair would be preferable, especially if dealing with a macular location.
