Suture fixation of dislocated endothelial grafts

PURPOSE: To share the experience of suturing the displaced endothelial grafts in three patients who developed this complication following a posterior endothelial keratoplasty. METHODS: Prospective evaluation of three patients who underwent surgical revision by suture fixation for dislocated endothelial graft. The surgeries were performed immediately after noting the complication during the post-op visits and were followed up for 6 months. Assessments at follow-up visits include visual acuity, pachymetry, endothelial cell count, topography, and corneal slit-lamp digital photography. RESULTS: No significant postoperative complications were encountered in any of the three eyes after graft suturing. The vision was worse than hand movements in all, following the graft dislocation and this improved to an average of 20/50 at 6-month post-op. In two of the three eyes the endothelial cell count reduced from 2600 cells preoperatively to 1251 and 988 cells, respectively. Mean topographic astigmatism after the suture removal was 2.4 D. CONCLUSION: Suture fixation of early endothelial graft dislocation seems to be a good alternative in dislocated endothelial discs as it provides a good refractive and visual outcome, instead of converting it to a standard full-thickness penetrating keratoplasty.