Corneal allograft rejection after Descemet stripping automated endothelial keratoplasty (DSAEK): report of three cases

Introduction. - Descemet stripping automated endothelial. keratoplasty (DSAEK) is an exciting alternative to standard full-thickness penetrating keratoplasty (PK) for the treatment of patients suffering from endothelial failure of the cornea. Corneal, transplant rejection is the leading cause of endothelial failure after PK. While DSAEK may reduce the risk of corneal allograft rejection, endothelial rejection can still occur. Case reports. - We report three cases of endothelial rejection after DSAEK. Subacute endothelial rejection occurred in all three cases after the topical steroid treatment regimen had been stopped. Conclusion. - A lower rejection rate in comparison with PK cannot be assumed and comparative studies are necessary. Extended topical steroid may be used. Subacute endothelial graft rejection implies that the patient needs to be fully informed of the functional signs and the need to seek medical advice immediately. (C) 2009 Elsevier Masson SAS. All rights reserved.