ABSTRACT
The authors report the successful use of Descemet's stripping automated endothelial keratoplasty (DSAEK) to treat a 45-year-old woman with amantadine-associated corneal edema. Discontinuation of the medication and treatment with corticosteroids did not result in resolution of the edema. The patient underwent sequential phakic DSAEK in both eyes with significant anatomic, visual, and functional improvement. Histopathologic analysis of Descemet's membrane by light microscopy revealed a paucity of endothelial cells. This case highlights the importance of considering amantadine toxicity in the differential diagnosis of corneal edema without an identifiable ocular cause and suggests the utility of DSAEK in the treatment of this rare condition.
AUTHORS
From the Cole Eye Institute (CTH, RHSL, WJD); the Transplant Center, Surgery Institute (RHSL, WJD); and the Departments of Anatomic Pathology (LRS) and Biomedical Engineering (WJD), Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
Originally submitted June 28, 2009. Accepted for publication April 23, 2010. Posted online July 29, 2010.
Supported in part by grant 1KL2RR024990 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research, and a Research to Prevent Blindness Challenge Grant to the Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Dr. Dupps is a recipient of a Research to Prevent Blindness Career Development Award.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to William J. Dupps, Jr., MD, PhD, Cleveland Clinic Cole Eye Institute, 9500 Euclid Avenue/i-32, Cleveland, OH 44195. E-mail: bjdupps@sbcglobal.net
doi: 10.3928/15428877-20100726-11
