Phototherapeutic keratectomy for anterior stromal fibrosis following DMEK

PURPOSE: Anterior stromal fibrosis is often seen in advanced cases of Fuchs endothelial dystrophy or secondary endothelial insufficiency. As Descemet membrane endothelial keratoplasty (DMEK) can completely eliminate the corneal edema and the guttae in these patients, anterior stromal fibrosis often remains leading to a reduction in visual function. OBSERVATIONS: In such situations phototherapeutic keratectomy can be an effective tool to remove the opacifications in the anterior corneal stroma and improve the visual function as presented in two clinical cases. CONCLUSION: DMEK can be the method of choice even in advanced cases of endothelial insufficiency with clinical significant fibrosis of the anterior corneal stroma.