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Clinical course and origin of epithelium in cases of epithelial downgrowth after Descemet stripping automated endothelial keratoplasty.

Publication ,  Journal Article
Itty, S; Proia, AD; DelMonte, DW; Santaella, RM; Carlson, A; Allingham, RR
Published in: Cornea
November 2014

PURPOSE: The aim of this study was to report a case series of epithelial downgrowth associated with Descemet stripping automated endothelial keratoplasty (DSAEK) and to explore the origin of the anterior chamber corneal epithelium. METHODS: This is a case series and literature review. RESULTS: Three histopathologically confirmed cases of epithelial downgrowth after DSAEK were identified. All cases were treated with argon laser ablation, intracameral 5-fluorouracil, and intraocular surgery. Recurrent epithelial downgrowth occurred in 2 of 3 cases. Fluorescent in situ hybridization analysis with fluorescent probes for X and Y chromosomes was used to analyze epithelial downgrowth tissues in all cases. All 3 cases were consistent with donor tissue origin of epithelial downgrowth tissue. However, this could only be confirmed in 1 case. The donor and the recipient were the same sex in 2 cases; thus, no definitive conclusion was possible in these patients. CONCLUSIONS: There have been multiple reports of epithelial downgrowth after DSAEK. We include additional evidence to support the role of donor tissue corneal cells as the source of epithelium in some of these cases. It is surprising that donor tissue would be tolerated immunologically by the patient in these cases. We propose that tolerance for donor epithelium may be mediated through anterior chamber-associated immune deviation.

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Published In

Cornea

DOI

EISSN

1536-4798

Publication Date

November 2014

Volume

33

Issue

11

Start / End Page

1140 / 1144

Location

United States

Related Subject Headings

  • Tissue Donors
  • Postoperative Complications
  • Ophthalmology & Optometry
  • Male
  • Karyotyping
  • In Situ Hybridization, Fluorescence
  • Humans
  • Fuchs' Endothelial Dystrophy
  • Female
  • Epithelium, Corneal
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Itty, S., Proia, A. D., DelMonte, D. W., Santaella, R. M., Carlson, A., & Allingham, R. R. (2014). Clinical course and origin of epithelium in cases of epithelial downgrowth after Descemet stripping automated endothelial keratoplasty. Cornea, 33(11), 1140–1144. https://doi.org/10.1097/ICO.0000000000000234
Itty, Sujit, Alan D. Proia, Derek W. DelMonte, Ricardo M. Santaella, Alan Carlson, and R Rand Allingham. “Clinical course and origin of epithelium in cases of epithelial downgrowth after Descemet stripping automated endothelial keratoplasty.Cornea 33, no. 11 (November 2014): 1140–44. https://doi.org/10.1097/ICO.0000000000000234.
Itty S, Proia AD, DelMonte DW, Santaella RM, Carlson A, Allingham RR. Clinical course and origin of epithelium in cases of epithelial downgrowth after Descemet stripping automated endothelial keratoplasty. Cornea. 2014 Nov;33(11):1140–4.
Itty, Sujit, et al. “Clinical course and origin of epithelium in cases of epithelial downgrowth after Descemet stripping automated endothelial keratoplasty.Cornea, vol. 33, no. 11, Nov. 2014, pp. 1140–44. Pubmed, doi:10.1097/ICO.0000000000000234.
Itty S, Proia AD, DelMonte DW, Santaella RM, Carlson A, Allingham RR. Clinical course and origin of epithelium in cases of epithelial downgrowth after Descemet stripping automated endothelial keratoplasty. Cornea. 2014 Nov;33(11):1140–1144.

Published In

Cornea

DOI

EISSN

1536-4798

Publication Date

November 2014

Volume

33

Issue

11

Start / End Page

1140 / 1144

Location

United States

Related Subject Headings

  • Tissue Donors
  • Postoperative Complications
  • Ophthalmology & Optometry
  • Male
  • Karyotyping
  • In Situ Hybridization, Fluorescence
  • Humans
  • Fuchs' Endothelial Dystrophy
  • Female
  • Epithelium, Corneal