Отчет о клиническом случае спонтанного очищения роговицы после субтотального отслоения трансплантата после комбинированной Descemet

Fuchs' Endothelial Corneal Dystrophy (FECD) is a bilateral, sporadic or autosomal dominant, non-inflammatory corneal dystrophy characterized by the progressive loss of corneal endothelial cells. These cells that regulate outflow of aqueous humor to the stroma and serve as a barrier with their pump mechanics are damaged, thus resulting in significant corneal edema. Over the past century, penetrating keratoplasty (PK) has gradually been replaced by more modern techniques such as Descemet's Stripping Endothelial Keratoplasty (DSAEK) and Descemet's Membrane Endothelial Keratoplasty (DMEK). While DMEK has been proven to attain better post-operative best corrected visual acuity (BCVA), it has presented the challenge of more frequent postoperative graft detachments.^1,2 Combined cataract surgery along with DMEK has also been reported to increase the risk of early postoperative graft detachment.³

While several case reports have illustrated spontaneous corneal clearance after significant graft detachment, the question regarding how much donor tissue is required to achieve and maintain corneal clearance and to ensure long term optimal visual outcomes remains. In this case report, we describe an event of spontaneous corneal clearance after near subtotal graft detachment noted in the early postoperative period in a patient with FECD who underwent combined DMEK and phacoemulsification with intraocular lens placement. We aim to provide insight on the mechanism behind corneal rehabilitation and add to the literature regarding the management of patient's with FECD.