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Posterior Dislocation of Descemet Stripping Automated Endothelial Keratoplasty Graft Can Lead to Retinal Detachment

Purpose: To describe traction retinal detachment as a complication of posterior dislocation of Descemet stripping automated endothelial keratoplasty (DSAEK) graft. Methods: Vitrectomy surgery was performed in 3 eyes that developed posterior dislocation of DSAEK graft. Intraoperatively, the corneal tissue was found to be adherent to the retina. In 2 cases, a retinal detachment with proliferative vitreoretinopathy (PVR) was already present and the donor DSAEK flap was found to be fused with the retina. In 1 case, the retina was attached at the time of surgery but PVR subsequently developed despite near total removal of the graft, requiring an additional procedure to achieve retinal reattachment. Results: Corneal tissue removal with a vitreous cutter was attempted in all cases. Residual tissue that had fused with the retina was left in place. Retinal reattachment was achieved with silicone oil injection in 2 cases and scleral buckle alone in 1 case. Conclusions: Posterior segment dislocation of a DSAEK flap and its adherence to the retina may cause PVR and traction retinal detachment. Early removal is warranted when dislocation occurs.