title: Spontaneous corneal clearance despite graft removal in Descemet stripping endothelial keratoplasty in Fuchs endothelial dystrophy.
abstract: OBJECTIVE
  To report spontaneous corneal clearing with improved visual acuity and central endothelial cell repopulation after the removal of a dislocated donor button following Descemet stripping endothelial keratoplasty (DSEK).
  
  
  METHODS
  Interventional case report.
  
  
  RESULTS
  An 84-year-old woman with decreased visual acuity in the right eye secondary to Fuchs endothelial dystrophy and cataract underwent combined cataract extraction, intraocular lens implantation, and DSEK. After primary graft failure, the resulting detached, opaque, and retracted donor lenticule was removed from the eye 2 months after the initial surgery and not replaced. The cornea started to clear after the donor button removal with central endothelial cell repopulation.
  
  
  CONCLUSIONS
  Corneal deturgescence is not strictly dependent on donor lenticule adhesion to the host posterior stromal surface. Endothelial cell migration and repopulation of the central cornea can occur after DSEK and after the removal of the failed endothelial graft, with corneal clearing and improved visual outcomes.
authors.affiliation: Imperial College Healthcare NHS Trust, Western Eye Hospital, London, United Kingdom. mahdi207@yahoo.com
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ziaei
authors.forename: Allon
authors.initials: A
authors.lastname: Barsam
authors.forename: Ali A
authors.initials: AA
authors.lastname: Mearza
mesh_terms: D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D002452:Cell Count; D003315:Cornea / Q000503:physiopathology*; D055954:Corneal Endothelial Cell Loss / Q000473:pathology; D003886:Descemet Membrane; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology / Q000601:surgery*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000150:complications / Q000601:surgery*; D006084:Graft Rejection / Q000209:etiology / Q000601:surgery*; D006801:Humans; D019654:Lens Implantation, Intraocular; D018918:Phacoemulsification; D017211:Treatment Failure; D014792:Visual Acuity / Q000502:physiology