**4.2 Case 2**

122 Keratoplasties – Surgical Techniques and Complications

Fig. 1.b Retained Descemet's membrane after PK treated with YAG laser

behind the graft on the first postoperative control by slit lamp examination.

corneal sectors, she underwent a retransplantation on February 26, 2003.

Hospital of Pavia, may help to illustrate the course and prognosis of this mishap.

Descemet's membrane leaves behind.

visual acuity of 1/10 with +2 D sphere.

the first tear to create a central circular 2.5 mm opening.

**4. Cases report** 

month after PK.

sphere.

**4.1 Case 1** 

This complication consists in the incomplete removal of the host cornea: after partial trephination we make an opening into the anterior chamber and introduce curved corneal scissors. Especially in an oedematous cornea it could occur that the lower blade is placed anterior to Descemet's membrane so that, when the button is lifted from the eye, a portion of

The result is a wavy, diaphanous membrane that creates a supernumerary anterior chamber

The following case histories from the Department of Ophthalmology of San Matteo General

A 62 year old white woman underwent penetrating keratoplasty in her right eye on April 23, 2002. Because of the appearance of deep new vessels, especially in nasal and upper

On the first post-operative control, slit lamp biomicroscopy revealed a retained Descemet's membrane and a supernumerary anterior chamber. The graft was clear with a best corrected

The patient opted for Laser treatment (March 2003) to improve visual function so that it was created a central circular opening in the retrograft membrane at optical zone level just one

The laser was setted to 0.9 mJ with posterior focus shift and increased up to 1.7 mJ when a central tear appeared in the membrane; subsequently enlarged focusing the beam near to

There were no complication resulting from the Yag Laser treatment and the donor cornea remained thin and clear with a visual acuity two years after PK improved to 6/10 with +2 D A 54 year old white woman was referred to our department on December 2002. The patient was diagnosed as having glaucoma in 1990 and since than on she was treated with Timololo. In 1998 a cataract extraction was performed in patient's right eye and on December 03, 2002 she underwent a penetrating keratoplasty in RE for endothelial decompensation. After surgery the patient reported excellent visual function lasting for some time but on July 2003 she had experienced decreased visual acuity and marked diffuse corneal oedema, later on which it was performed a retransplantation.

On the first post-operative control the slit lamp biomicroscopy revealed a Descemet's retention with a supernumerary anterior chamber so that the patient underwent descemetorhexis to leave the pupillary field one month later. Nine months after the treatment the patient had a best-corrected visual acuity of 5/10 and the graft was clear. Unfortunately the patient did not complete the follow-up in our department.
