Descemet Membrane Endothelial Keratoplasty for Late Corneal Edema Secondary to Obstetrical Forceps–Related Tears

Abstract

Purpose: The purpose of our paper is to describe the outcome of Descemet membrane endothelial keratoplasty (DMEK) in patients with a history of known obstetrical forceps–related tears who developed clinically significant corneal edema in their eighth decade of life. Methods: Case series. Results: Two patients with a known history of obstetrical forceps–related tears presented with corneal edema and vertical tears of Descemet membrane consistent with birth trauma. DMEK was performed for both cases. Case 1 underwent pseudophakic DMEK, and Case 2 underwent combined phacoemulsification and DMEK (triple-DMEK). DMEK grafts were fully attached in both cases at postoperative 1-day and 1-week appointments, as confirmed on slit-lamp examination and anterior segment optical coherence tomography. There was marked improvement in best-corrected visual acuity and corneal edema in both patients. Conclusions: We demonstrate that DMEK can afford excellent results in patients with a history of obstetrical forceps injury, who experience corneal edema later in life. In addition, we show that the triple-DMEK can be done successfully in this entity.