“Mouse Sign” on Optical Coherence Tomography of Detached Endothelial Graft Indicates Graft Inversion

PURPOSE: To report the mouse-like configuration of detached endothelial keratoplasty graft observed on optical coherence tomographic imaging after pre-Descemet's endothelial keratoplasty (PDEK). CASE REPORT: Three eyes of 3 patients who underwent PDEK and had graft detachment in the initial postoperative period of <2 weeks were examined. Fourier domain optical coherence tomography was performed in all eyes. All 3 patients had partial graft detachment with the detached region involving the central and inferior cornea. One end of the graft formed a thick convex scroll detaching outward, downward, and upward, and the other end was attached to the edematous cornea forming the ‘mouse’ configuration. The graft was inverted, and rebubbling failed in all 3 eyes. Graft exchange was required. CONCLUSION: Mouse sign in OCT imaging indicates the possibility of an inverted graft and predicts unsuccessful rebubbling. Graft exchange is required in such eyes.