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[Recurrent DMEK failure].

C Matar1, B Seitz2, L Daas2

  • 1Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str. 100, 66424, Homburg/Saar, Deutschland. Cedricmatar@uks.eu.

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|July 31, 2020
PubMed
Summary
This summary is machine-generated.

A patient with Fuchs dystrophy experienced recurrent graft failure after three Descemet Membrane Endothelial Keratoplasties (DMEK). Herpes simplex virus (HSV) infection was detected and treated, leading to successful corneal clarity and vision recovery.

Keywords:
Cystoid macular edemaDescemet Membrane Endothelial KeratoplastyEndotheliitisGraft failureHerpetic uveitis

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Area of Science:

  • Ophthalmology
  • Virology

Background:

  • Fuchs dystrophy is a progressive eye condition affecting the cornea.
  • Descemet Membrane Endothelial Keratoplasty (DMEK) is a surgical procedure to treat corneal endothelial dysfunction.

Observation:

  • A patient with Fuchs dystrophy underwent three DMEK surgeries due to recurrent graft failure, elevated intraocular pressure, and cystoid macular edema.
  • Herpes simplex virus (HSV) was identified in the anterior chamber during the third DMEK procedure.

Findings:

  • Initiation of antiviral therapy led to complete resolution of macular edema.
  • At six months post-treatment, the cornea remained clear, visual acuity improved to 0.8, and intraocular pressure normalized.
  • The HSV infection may have been a reactivation of a latent patient infection or transmitted via the donor graft (ping-pong transmission).

Implications:

  • This case highlights the potential for HSV reactivation or transmission during DMEK procedures.
  • Early detection and management of viral infections are crucial for successful corneal transplantation outcomes.
  • Further investigation into donor graft screening for latent viruses may be warranted to prevent transmission.