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Blossoming vision: unusual donor tissue configuration in a jaundiced cornea tissue

Published:October 08, 2020DOI:https://doi.org/10.1016/j.jcjo.2020.09.009
      A patient underwent a left phacoemulsification, intra-ocular lens (IOL) insertion, and Descemet membrane endothelial keratoplasty (DMEK). The donor tissue had excellent endothelial cell count and was compliant with regulatory screening protocols. The donor patient died from hepatic failure and was noted to be severely jaundiced, consistent with the diffuse yellow tinge found in the corneal stroma. A standard 8 mm DMEK peeling was initiated uneventfully, with the tissue being more robust and stiffer than normal. However, the peripheral rim of the DMEK tissue folded in an uncharacteristic petaloid and then sinusoidal configuration (Fig. 1). The patient had an uncomplicated procedure and is doing well.
      Fig 1
      Fig. 1Petaloid (A) and sinusoidal “yin and yang” (B) peripheral rim of Descemet membrane endothelial keratoplasty configuration stained with trypan blue on a background of a jaundiced stroma.
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