Posterior dislocation of descemet stripping automated endothelial keratoplasty graft can lead to retinal detachment.

PURPOSE: To describe traction retinal detachment as a complication of posterior dislocation of Descemet stripping automated endothelial keratoplasty (DSAEK) graft.

METHODS

Vitrectomy surgery was performed in 3 eyes that developed posterior dislocation of DSAEK graft. Intraoperatively, the corneal tissue was found to be adherent to the retina. In 2 cases, a retinal detachment with proliferative vitreoretinopathy (PVR) was already present and the donor DSAEK flap was found to be fused with the retina. In 1 case, the retina was attached at the time of surgery but PVR subsequently developed despite near total removal of the graft, requiring an additional procedure to achieve retinal reattachment.

RESULTS

Corneal tissue removal with a vitreous cutter was attempted in all cases. Residual tissue that had fused with the retina was left in place. Retinal reattachment was achieved with silicone oil injection in 2 cases and scleral buckle alone in 1 case.

CONCLUSIONS

Posterior segment dislocation of a DSAEK flap and its adherence to the retina may cause PVR and traction retinal detachment. Early removal is warranted when dislocation occurs.