Late Onset Corneal Epithelial Bleb Following DMEK

Authors

Steven B. Koenig, MD, Lisa R. Koenig, BA

Keywords

DMEK, epithelial bullae, corneal edema

Abstract

Purpose: To report the case of a late onset large corneal epithelial
bleb following uncomplicated Descemet’s membrane endothelial
keratoplasty (DMEK).

Patient and Methods: A 78 y.o. man underwent uncomplicated
DMEK for pseudophakic bullous keratopathy in the right eye.
Results: On post-operative day one, the anterior segment optical
coherence tomography revealed a small peripheral detachment
of the Descemet’s membrane at 10 o’clock. Despite a clear graft
that appeared attached clinically, he developed a late onset large
corneal epithelial bleb that contributed to visual loss. The lesion
was successfully removed with simple corneal epithelial debridement
resulting in a clear cornea.

Conclusions: Late onset corneal epithelial bleb formation may
occur after uncomplicated DMEK surgery. Although the exact
mechanism remains unclear, it most likely resulted from an
occult persistent focal detachment of the donor graft.