Histologic and Ultrastructural Findings in a Case of Traumatic Graft Failure in Deep Lamellar Endothelial Keratoplasty
Bibliographic record
Abstract
PURPOSE: Few complications have been reported for deep lamellar endothelial keratoplasty (DLEK). Endothelial graft failure has rarely been disclosed as a complication. Although the histopathologic and ultrastructural analysis of a failed DLEK graft has been previously described, we are not aware of any reports of these features in a case of traumatic endothelial graft failure. METHODS: We report a case of an 85-year-old man with Fuchs endothelial dystrophy who underwent DLEK for corneal decompensation after cataract extraction and intraocular lens implantation. The graft had dislocated by the fourth postoperative day and was repositioned the following day. Penetrating keratoplasty was performed 3 months later for gradually progressive intractable corneal edema. The excised cornea underwent histochemical, immunohistochemical, and ultrastructural analysis. RESULTS: Marked endothelial loss resulting in corneal decompensation was diagnosed histopathologically. The graft-host interface line showed no substantial findings for the following histochemical and immunohistochemical stains: colloidal iron, alcian blue (pH 2.5), vimentin, epithelial membrane antigen (EMA), smooth muscle actin (SMA), anti-cytokeratin CAM 5.2, high-molecular-weight keratin, anti-cytokeratin AE1/AE3, and collagen 3. The cornea showed ultrastructural changes similar to, but more pronounced than, those observed in corneas after laser in situ keratomileusis. CONCLUSIONS: This is the second described case of endothelial graft failure after DLEK. Histochemical and ultrastructural analysis revealed that the DLEK-operated cornea contained irregularities that may interfere with optical performance.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".