title: Intracorneal epithelial ingrowth after descemet stripping endothelial keratoplasty and stromal puncture.
abstract: OBJECTIVE
  To report a case of intracorneal epithelial ingrowth after Descemet stripping endothelial keratoplasty (DSEK) with stromal puncture for phakic bullous keratopathy.
  
  
  METHODS
  A 35-year-old man underwent DSEK for phakic bullous keratopathy in his right eye after an episode of trauma some years ago. Intraoperative drainage of interlamellar fluid was assisted by stromal punctures. Postoperatively, the patient had a best-corrected visual acuity of 20/40 in his right eye. A small area of epithelial ingrowth appeared in the corneal intrastromal interface inferiorly as an irregular flat haze about a month after surgery. It was in continuity with the inferior stromal puncture incision made intraoperatively. By 10 months, the epithelial pearls became confluent and homogenously white with a sharp demarcation.
  
  
  RESULTS
  Because the epithelial ingrowth remained stationary till the last follow-up (13 months), no surgical intervention was planned. The central visual axis was clear and the best-corrected visual acuity was 20/40.
  
  
  CONCLUSIONS
  Epithelial ingrowth into the cornea may occur after an uncomplicated DSEK with stromal puncture. Patients undergoing DSEK should be closely monitored for development and progression of intracorneal epithelial ingrowth, especially when stromal punctures have been made to drain interface fluid.
authors.affiliation: Department of Ophthalmology, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Reema
authors.initials: R
authors.lastname: Bansal
authors.forename: Aparna
authors.initials: A
authors.lastname: Ramasubramanian
authors.forename: Pranab
authors.initials: P
authors.lastname: Das
authors.forename: Jaspreet
authors.initials: J
authors.lastname: Sukhija
authors.forename: Arun K
authors.initials: AK
authors.lastname: Jain
mesh_terms: D000328:Adult; D003316:Corneal Diseases / Q000601:surgery; D003319:Corneal Stroma / Q000601:surgery*; D016039:Corneal Transplantation; D003886:Descemet Membrane / Q000601:surgery*; D004728:Endothelium, Corneal / Q000637:transplantation*; D019573:Epithelium, Corneal / Q000473:pathology*; D015807:Eye Injuries, Penetrating / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011677:Punctures; D014792:Visual Acuity / Q000502:physiology