Review Article

Etiopathogenesis and Therapy of Epithelial Ingrowth after Descemet’s Stripping Automated Endothelial Keratoplasty

Table 1

Literature review of epithelial migration into anterior chamber after DSAEK.

StudyNumeber of eye(s)DescriptionDiagnosisGraft failureTreatment

Culbertson [13]1Epithelial downgrowthConfocal microscopyNoPK

Koenig and Covert [17]1Epithelial ingrowth,interfaceHistologyYesRepeat DSAEK

Walker et al. [19]1Epithelial downgrowth, at the interfaceConfocal microscopy, histologyNoPK

Prasher et al. [9]2Case  1-epithelial downgrowth, interfaceHistologyYesCase  1 had PK
Case  2-epithelial downgrowth, not at the interfaceCase  2 had DSAEK

Phillips et al. [14]1Conjunctival epithelial downgrowth, over donor endotheliumHistologyYesRepeat DSAEK

Gorovoy and Ratanasit [5]1Epithelial downgrowth, not at the interfaceHistologyYesRepeat DSAEK

Saelens et al. [11]1Epithelial ingrowth in the flap-graft interfaceHistologyPosterior mushroom keratoplasty

Lee et al. [24]1Epithelial ingrowth at the interfaceHistologyYesRepeat DSAEK

Suh et al. [18]5Epithelial ingrowth interface-1AS-OCT-1, spectral domainNone documentedObservation in 4 cases
Interface retrocorneal-4Ultrahigh resolution OCT-3, histology-1Corneoscleral grafting in one case

Bansal et al. [8]1Epithelial ingrowth after stromal punctureClinicalNoNil

Ghosh et al. [16]1Epithelial ingrowth interfaceHistologyYesRepeat DSAEK

Wong et al. [34]1Interface haze (atypical presentation of epithelial ingrowth interface)Slit lamp, translucent membrane whitened after argon laser photocoaugulationYes3 DSAEKs 
intracameral 5-FU

DSAEK: Descemet stripping automated endothelial keratoplasty; PK: penetrating keratoplasty; AS-OCT: anterior segment optical coherence tomography; OCT: optical coherence tomography.