title: Epithelial ingrowth in the flap-graft interface after microkeratome-assisted posterior penetrating keratoplasty.
abstract: A 79-year-old woman with pseudophakic bullous keratopathy had microkeratome-assisted posterior keratoplasty for the treatment of clinically significant corneal edema. An island of epithelial ingrowth was noted in the flap-graft interface that was not communicating with the flap periphery. Partial lifting of the anterior corneal flap and removal and irrigation of the epithelial cells were successfully performed. A review of reports of microkeratome-assisted posterior penetrating keratoplasty shows epithelial ingrowth is common after this procedure. The presence of posterior sutures, a central location of the epithelial cells, communication with the periphery, and evidence of stromal melting should prompt immediate surgical intervention.
authors.affiliation: Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Victor L
authors.initials: VL
authors.lastname: Perez
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Colby
authors.forename: Dimitri T
authors.initials: DT
authors.lastname: Azar
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000209:etiology* / Q000601:surgery; D003319:Corneal Stroma / Q000473:pathology*; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects* / Q000295:instrumentation; D012086:Reoperation; D013524:Surgical Flaps / Q000473:pathology*; D014792:Visual Acuity