Oman Journal of Ophthalmology

LETTER TO THE EDITOR
Year
: 2012  |  Volume : 5  |  Issue : 1  |  Page : 67--68

Macrostriae in endothelial keratoplasty


Majid Moshirfar, Maylon Hsu 
 The University of Utah School of Medicine, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA

Correspondence Address:
Majid Moshirfar
The University of Utah School of Medicine John A. Moran Eye Center, University of Utah, 6360 S 3000 E # 200 Salt Lake City, UT 84121 6925
USA




How to cite this article:
Moshirfar M, Hsu M. Macrostriae in endothelial keratoplasty.Oman J Ophthalmol 2012;5:67-68


How to cite this URL:
Moshirfar M, Hsu M. Macrostriae in endothelial keratoplasty. Oman J Ophthalmol [serial online] 2012 [cited 2022 Jun 26 ];5:67-68
Available from: https://www.ojoonline.org/text.asp?2012/5/1/67/94795


Full Text

Sir,

We would like to congratulate Turaka et al., for their recently published article, Macrostriae and Descemet's membrane folds in the Descemet's stripping endothelial keratoplasty graft. [1] The authors describe a failed Descemet's stripping automated endothelial keratoplasty (DSAEK) with significant macrostriae requiring a repeat DSAEK. They provide excellent histopathological findings demonstrating the folds with associated endothelial atrophy.

We agree with the authors that having an edematous and thick graft may be a cause of persistent macrostriae. We have reported a similar case of graft folds in the visual axis which did not resolve over time. [2] However, our case did not lead to graft edema and failure, perhaps because it was a thinner graft. We have observed clinically that folds may occur in thinner grafts. As thin and ultra-thin DSAEK grafts are currently being studied to improve visual outcomes, [3] macrostriae may still be a complication. Thinner grafts are sometimes more difficult to manipulate surgically, and folds may occur intraoperatively. We thank the authors for sharing their findings. Whether macrostriae can only be attributed to thicker grafts is uncertain. We agree that more studies are needed to determine the etiology and improve management of this complication.

References

1Turaka K, Rapuano CJ, Eagle RC, Abazari A, Hammersmith KM. Macrostriae and Descemet's membrane folds in the Descemet's stripping endothelial keratoplasty graft. Oman J Ophthalmol 2011;4:90-1.
2Moshirfar M, Khalifa YM, Davis D, Fenzl CR, Espandar L, Chang JC, et al. Descemet stripping automated endothelial keratoplasty using donor corneas with previous laser in situ keratomileusis or photorefractive keratectomy: A case series and donor cap histopathology. Cornea 2011 Oct 11. [Epub ahead of print]
3Neff KD, Biber JM, Holland EJ. Comparison of central corneal graft thickness to visual acuity outcomes in endothelial keratoplasty. Cornea 2011;30:388-91.