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| LETTER TO THE EDITOR |
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| Year : 2012 | Volume
: 5
| Issue : 1 | Page : 67-68 |
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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
| Date of Web Publication | 7-Apr-2012 |
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
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-620X.94795
How to cite this article:
Moshirfar M, Hsu M. Macrostriae in endothelial keratoplasty. Oman J Ophthalmol 2012;5:67-8 |
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 | |  |
| 1. | Turaka 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. 
[PUBMED]  |
| 2. | Moshirfar 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]
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| 3. | Neff KD, Biber JM, Holland EJ. Comparison of central corneal graft thickness to visual acuity outcomes in endothelial keratoplasty. Cornea 2011;30:388-91.
[PUBMED] |
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