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Published on: July 6, 2015
Epithelial Ingrowth Following Endothelial Keratoplasty
Ritika R Dalal1, Irving Raber, Steven P Dunn
1*Private Practice, Mumbai, India; †Wills Eye Hospital, Philadelphia, PA; ‡Michigan Cornea Consultants, Southfield, MI; §Department of Ophthalmology, Upstate Medical University, Syracuse, NY; ¶Department of Ophthalmology, University of Illinois at Chicago (UIC); ‖Department of Ophthalmology, Rush Medical College, Chicago, IL; and **Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
Epithelial ingrowth after endothelial keratoplasty (EK) often presents as interface opacity and usually does not progress. Causes include surgical technique, but ingrowth is rarely linked to venting incisions.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Transplantation
Background:
- Endothelial keratoplasty (EK) is a common procedure for corneal diseases.
- Epithelial ingrowth is a rare but serious complication following EK.
- Understanding its causes and presentation is crucial for patient management.
Purpose of the Study:
- To analyze a case series of epithelial ingrowth post-EK.
- Identify common causes and clinical presentations.
- Determine the typical clinical course and effective treatments.
Main Methods:
- Retrospective study of 13 patients with post-EK epithelial ingrowth.
- Review of slit lamp images, diagnostic imaging, and histopathology.
- Analysis of medical records, operative details, and follow-up data.
- Literature review and meta-analysis.
Main Results:
- Epithelial ingrowth occurred most frequently in the interface, away from the visual axis.
- A homogeneous gray-white interface opacity was characteristic.
- Venting incisions were performed in 8 patients, with ingrowth linked in only one case.
- Nine patients were managed conservatively, while four required surgical intervention.
Conclusions:
- Epithelial ingrowth post-EK typically presents as interface opacity and is often asymptomatic.
- It most commonly occurs away from the visual axis and usually does not progress.
- Causes include surgical technique, eccentric trephination, or loose epithelium, with venting incisions being a rare cause.
