Descemet Stripping Automated Endothelial Keratoplasty for Repeated Penetrating Keratoplasty Graft Failure

Purpose: To report a case of Descemet stripping automated endothelial keratoplasty (DSAEK) for graft failure after re-penetrating keratoplasty (PK). Case summary: A 33-year-old man of Indian nationality who had developed right eye amoeba keratitis and had received two penetrating keratoplasties and allogeneic kerato-limbal transplant in India sought treatment at our hospital. During the follow-up, Ahmed valve transplantation was performed under the diagnosis of secondary glaucoma in his right eye; the patient also underwent conjunctival recession and conjunctival permanent amniotic membrane transplantation as corneal neovascularization had progressed. Subsequently, the corneal transplantation failed and DSAEK was performed. At 7 months after the operation, the right-eye visual acuity was 20/320 without any complications. Conclusions: DSAEK may restore good vision without complications in patients with repeated corneal graft failure after PK from corneal endothelial cell failure followed by corneal neovascularization and glaucoma surgery but with good stromal conditions. We present this case, along with a review of the literature. Future studies will require more surgical patients. J Korean Ophthalmol Soc 2021;62(3):394-399