Question

What are the complications after endothelial keratoplasties?

Hint:

Proper graft ha
ndling, post-operative care, and monitoring for complications like graft detachment and rejection are essential to the success of endothelial keratoplasty.

Answer 1

Endothelial keratoplasties, such as DSEK and DMEK, have revolutionized the treatment of corneal endothelial diseases. However, like all surgeries, these procedures are associated with potential complications:
1. Graft Failure:
- Endothelial cell loss can lead to graft failure over time, resulting in the need for repeat surgery.
2. Graft Detachment:
- Graft dislocation or detachment is a common complication, especially in the early postoperative period. It may require repositioning or re-grafting in some cases.
3. Infection:
- Infection, including endophthalmitis, can occur after the surgery, though it is rare. It can lead to permanent vision loss if not managed promptly.
4. Raised Intraocular Pressure (IOP):
- Elevated IOP can occur due to inflammation, especially in the early postoperative period. This can lead to glaucoma if not managed.
5. Rejection Reaction:
- Graft rejection is a rare but serious complication, which can lead to graft failure. Symptoms include redness, pain, and reduced vision. Steroid treatment may be required to manage this.
6. Double Vision (Diplopi:
- Some patients may experience double vision, particularly in the early recovery phase due to corneal irregularities or astigmatism.
7. Cataract Formation:
- Although rare, cataracts may develop in the host lens after surgery, especially in older patients or those with pre-existing lens opacities.