Purpose: 

The purpose of this study was to report a Descemet membrane endothelial transfer (DMET) in a patient with pseudophakic bullous keratopathy (PBK) who developed graft dislocation after manual Descemet stripping endothelial keratoplasty.

Methods: 

A 60-year-old man presented with defective vision in the left eye; after Descemet stripping endothelial keratoplasty, graft dislocation was noted 1 month after surgery.

Results: 

Corneal clarity was improving slowly over 3 months without any secondary surgical intervention. The mechanism of DMET and the review of literature were enunciated.

Conclusions: 

DMET occurs commonly in eyes with Fuch endothelial dystrophy and rarely in patients with PBK. The mechanism of DMET in PBK probably occurs because of migration of the donor endothelial cells from partially attached Descemet stripping endothelial keratoplasty grafts to the host stroma, in contrast to Fuch endothelial dystrophy, where the endothelial cells from the periphery migrate to the center. Hence, waiting for spontaneous corneal clarity is pivotal because of DMET even in patients with PBK for at least 3 months.

中文翻译：

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DSEK 术后后弹力层内皮移植 (DMET) 治疗假性晶状体大疱性角膜病 — 病例报告及文献复习

目的： 

本研究的目的是报告一名人工晶状体大疱性角膜病 (PBK) 患者的后弹力层内皮移植 (DMET)，该患者在手动后弹力层剥离内皮角膜移植术后出现移植物脱位。

方法： 

一名 60 岁男子左眼视力有缺陷；后弹力层剥离内皮角膜移植术后1个月发现移植物脱位。

结果： 

角膜清晰度在 3 个月内缓慢改善，无需任何二次手术干预。阐述了DMET的作用机制并进行了文献综述。

结论： 

DMET 常见于患有 Fuch 内皮营养不良的眼睛，很少发生于 PBK 患者。PBK 中 DMET 的机制可能是由于供体内皮细胞从部分附着的后弹力层剥离内皮角膜移植移植物迁移到宿主基质，与 Fuch 内皮营养不良相反，Fuch 内皮营养不良是内皮细胞从周边迁移到中心。因此，即使对于 PBK 患者，等待角膜自发澄清也至关重要，因为 DMET 至少要等待 3 个月。