Histopathological findings of failed grafts following Descemet’s stripping automated endothelial keratoplasty (DSAEK) Hind Alkatan, MD, Ali Al-Rajhi,

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Presentation transcript:

Histopathological findings of failed grafts following Descemet’s stripping automated endothelial keratoplasty (DSAEK) Hind Alkatan, MD, Ali Al-Rajhi, MD, FRCS, FRCOphth, Ali Al-Shehri, MD, Ali Khairi, MD Saudi Journal of Ophthalmology Volume 26, Issue 1, Pages 79-85 (January 2012) DOI: 10.1016/j.sjopt.2011.05.006 Copyright © 2012 Terms and Conditions

Figure 1a An example of primary graft failure in the left eye. Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 1b Corresponding histopathological appearance of his DSAEK graft (specimen 11) showing endothelial attenuation (periodic acid–Schiff, original magnification ×200). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 2a Clinical photo of the right eye in another failed DSAEK case. Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 2b Histopathologic appearance of the same case (specimen 12) with thick DSAEK flap and retained host DM (periodic acid–Schiff, original magnification ×200). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 3a Clinical photo of failed reattachment of the DSAEK flap in the right eye. Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 3b Fibrous ingrowth along host–graft interface in the same case (specimen 3) indicated by the black arrow (periodic acid–Schiff, original magnification ×400). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 4a Epithelial ingrowth (arrow) at the graft–host interface of specimen 7 (hematoxylin–eosin, original magnification ×200). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 4b Cytokeratin positive epithelial ingrowth (cytokeratin, original magnification ×400). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 5a Fungal stromal keratitis of the flap in specimen 2 (periodic acid–Schiff, original magnification ×400). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 5b Yeast within the graft stroma (Grocott methenamine silver, original magnification ×1000 oil immersion). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions

Figure 6 Stromal amyloid deposits within the stroma (Congo red, original magnification ×200). Saudi Journal of Ophthalmology 2012 26, 79-85DOI: (10.1016/j.sjopt.2011.05.006) Copyright © 2012 Terms and Conditions