Corneal transplantation for endothelial pigmentation

Endothelial pigmentation does not usually interfere with vision. This case report documents a dense and extensive deposition of uveal pigment in corneal endothelial cells of a patient who had undergone 2 previous grafts subsequent to an alkali burn injury. The previous graft in which the pigmentation occurred remained compensated, but vision was impaired secondary to dense endothelial pigmentation. A combination of the initial chemical injury, recurrent iritis, chronic glaucoma, and multiple intraocular procedures may have resulted in the stimulus for the uveal tract to disperse a large amount of pigment onto the cornea and its subsequent phagocytosis by the endothelium. Endothelial pigmentation may become a more commonly seen complication in attempts to treat the severely damaged anterior segment.