title: [Immunological graft rejection with Khodadoust line after "Descemet stripping automated endothelial keratoplasty" (DSAEK)].
abstract: BACKGROUND
  Over the past decade endothelial keratoplasty has become the treatment of choice for patients with corneal endothelial dysfunction.
  
  
  METHODS
  "Descemet stripping automated endothelial keratoplasty" (DSAEK) is one of the most widespread forms of posterior endothelial keratoplasty. An improvement of visual acuity is achieved more quickly after DSAEK and the reduced amount of transplanted tissue in DSAEK seems to result in fewer instances of immunological graft rejection.
  
  
  OBJECTIVE
  The clinical signs of immunological graft rejection after DSAEK are not yet well known. Typically, an immunological rejection episode is combined with the presence of corneal edema, Descemet folds and retrocorneal precipitates restricted to the graft but a classical Khodadoust line seems to be rare.
  
  
  RESULTS
  The quick response after the combination of high-dose topical and systemic steroid therapy with steroid injection (80 μg fortecortin) in the anterior chamber in our patient confirms the necessity of a prompt and rapid immunosuppression.
  
  
  CONCLUSIONS
  Although the risk of graft rejection after DSAEK is rare, the use of immunosuppressants is important in both acute and long-term postoperative care of endothelial corneal transplantation.
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str. 100, Gebäude 22, 66424, Homburg/Saar, Deutschland. miltiadis.fiorentzis@uks.eu.
authors.forename: M
authors.initials: M
authors.lastname: Fiorentzis
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str. 100, Gebäude 22, 66424, Homburg/Saar, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Viestenz
authors.affiliation: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str. 100, Gebäude 22, 66424, Homburg/Saar, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Seitz
mesh_terms: D000368:Aged; D057111:Descemet Stripping Endothelial Keratoplasty / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006084:Graft Rejection / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids
keywords: Corneal transplantation; Immune reaction; Keratoplasty; Steroid therapy; Visual acuity