Abstract bekijken

Deze abstract is toegekend aan sessies
Type presentatieOral presentation
TitelUnusual occurrence of graft-host interface epithelial ingrowth imitating infection following DMEK surgery
DoelTo report our experience of interface epithelial ingrowth post-Descemet membrane endothelial keratoplasty (DMEK) surgery.
MethodesPatient was examined, diagnosed and treated by the corneal team in the Ophthalmology Department at University Hospitals of Leicester, a tertiary care hospital.
ResultatenAn 81-year-old female with Fuchs’ endothelial dystrophy, cataract and dry age-related macular degeneration underwent uncomplicated left triple DMEK surgery. Pre-operative left distance visual acuity was 0.50 LogMAR.

At 7 weeks post-operatively, multiple left graft-host interface opacities were noted and suspected to be of infectious origin. An emergency anterior chamber tap was performed for microbiology culture, and intra-cameral Voriconazole and Cefuroxime were injected. The patient was started on topical levofloxacin 0.5% and voriconazole 1% hourly. Topical dexamethasone 0.1% was stopped.

AS-OCT showed hyperreflective interface deposits corresponding to the opacities. Aqueous tap cultures were negative. Topical antimicrobial treatment was tapered and discontinued, and topical steroids were recommenced. The clinical diagnosis of epithelial ingrowth was made and confirmed by in vivo confocal microscopy (IVCM).

Despite progression, the patient remained asymptomatic with a visual acuity of 0.28 LogMAR 15.5 months post-operative.
ConclusieEpithelial ingrowth is a fairly unknown complication after DMEK surgery which can mimic an insidious infectious keratitis. Appropriate investigation and treatment are required, and IVCM may serve as a useful diagnostic modality in achieving the correct diagnosis.
BelangenverstrengelingNee
Auteur 1
NaamHOUBEN
InitialenI
InstituutUniversity Hospitals of Leicester NHS Trust
StadLeicester
Auteur 2
NaamDhillon
InitialenN
InstituutUniversity Hospitals of Leicester NHS Trust
StadLeicester
Auteur 3
NaamDarren
InitialenT
InstituutQueen's Medical Centre
StadNottingham
Auteur 4
NaamHarminder
InitialenD
InstituutQueen's Medical Centre
StadNottingham
top ^