Spontaneous Corneal Clearing after Descemet's Stripping without Endothelial Replacement

Purpose: To report spontaneous corneal clearing with improved visual acuity and central endothelial cell repopulation after Descemet's stripping without endothelial replacement. Design: Interventional case report. Methods: A 34-year-old woman with bilateral decreased vision secondary to corneal edema from endothelial dysfunction underwent Descemet's stripping endothelial keratoplasty (DSEK) in the right eye and Descemet's stripping only in the left eye. Histopathologic evaluation confirmed a dual diagnosis of Fuchs' endothelial dystrophy and posterior polymorphous membrane dystrophy from Descemet's membrane specimens removed from each eye. After primary graft failure with regraft in the right eye, the second posterior corneal lenticule detached and was removed and not replaced. The cornea cleared, and central endothelial cell repopulation was documented by confocal microscopy. Therefore, Descemet's stripping without endothelial replacement was performed in the left eye. The left cornea also cleared with central endothelial cell repopulation. Main Outcome Measures: Postoperative visual acuity and central endothelial cell repopulation. Results: Endothelial migration after Descemet's stripping alone in the left eye, with probable host endothelial cell repopulation in the right eye. Conclusions: Endothelial cell migration after Descemet's stripping procedure without insertion of endothelial graft can occur, resulting from host endothelial cell repopulation with corneal clearing and improved visual acuity. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2012; 119: 256-260 (C) 2012 by the American Academy of Ophthalmology.