[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-444883-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-444883-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","posterior-migration-of-a-descemet-membrane-endothelial-keratoplasty-graft-associated-with-macular-proliferative-changes","Posterior Migration of a Descemet Membrane Endothelial Keratoplasty Graft Associated With Macular Proliferative Changes","","Posterior migration of a Descemet membrane endothelial keratoplasty (DMEK) graft with macular proliferative changes is described in an open access case report. A 79-year-old man underwent DMEK for bullous keratopathy, but during graft manipulation the intraocular lens became unstable and the graft was lost from the anterior chamber. Two weeks later, OCT showed macular proliferative changes, and subsequent pars plana vitrectomy found the graft within the vitreous cavity with fibrovascular proliferation, allowing successful graft removal. The report highlights rare DMEK complications and the need for vigilant posterior segment evaluation.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/posterior-migration-of-a-descemet-membrane-endothelial-keratoplasty-graft-associated-with-macular-proliferative-changes/444883/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/posterior-migration-of-a-descemet-membrane-endothelial-keratoplasty-graft-associated-with-macular-proliferative-changes/444883.png","ImageObject",300,407,{"name":42,"@type":43},"Blue Pony","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What rare complication occurred after DMEK in this case?","Question",{"text":63,"@type":64},"During graft manipulation, the graft was lost from the anterior chamber and later was found to have migrated posteriorly into the vitreous cavity.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were the macular proliferative changes detected?",{"text":68,"@type":64},"Optical coherence tomography (OCT) two weeks postoperatively revealed macular proliferative changes without hemorrhage or peripheral ischemia.",{"name":70,"@type":61,"acceptedAnswer":71},"What surgery ultimately confirmed and treated the problem?",{"text":72,"@type":64},"Pars plana vitrectomy revealed the DMEK graft in the vitreous cavity, associated with fibrovascular proliferation, and the graft was successfully removed.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},444883,1790779553,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},962090760266,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Review began 12/27/2025  \nReview ended 01/02/2026  \nPublished 01/06/2026  \n© Copyright 2026  \nNezu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.100897  \nOpen Access Case Report  \nPosterior Migration of a Descemet Membrane Endothelial Keratoplasty Graft Associated With Macular Proliferative Changes  \nNaoki Nezu 1, Toshiki Shimizu 1 , Yorihisa Kitagawa 1, Takahiko Hayashi 1, Satoru Yamagami 1  \n1. Ophthalmology, Nihon University School of Medicine, Tokyo, JPN  \nCorresponding author: Takahiko Hayashi, [takamed@gmail.com](takamed@gmail.com)  \nAbstract  \nA 79-year-old male underwent descemet membrane endothelial keratoplasty (DMEK) for bullouskeratopathy. Intraoperatively, the intraocular lens (IOL) became unstable during graft manipulation, and the graft was lost from the anterior chamber. Postoperative examination failed to identify the graft. Two weeks later, optical coherence tomography (OCT) showed macular proliferative changes without hemorrhage or peripheral ischemia. Subsequent pars plana vitrectomy revealed the DMEK graft in the vitreous cavity, associated with fibrovascular proliferation. The graft was successfully removed. This case demonstrates a rare complication of DMEK and emphasizes the need for vigilance in eyes with compromised posterior capsule or zonules.  \nCategories: Ophthalmology  \nKeywords: dmek, graft dislocation, macular proliferation, vitrectomy, vitreous cavity  \nIntroduction  \nDescemet membrane endothelial keratoplasty (DMEK) has become the preferred surgical technique for the management of corneal endothelial dysfunction due to its rapid visual recovery and favorable graft survival compared with other forms of endothelial keratoplasty [1-3]. However, the procedure can be technically challenging, particularly in eyes with altered anterior or posterior segment anatomy. Eyes that have undergone prior vitrectomy represent a unique surgical subgroup, as the absence of vitreous support may predispose the graft to abnormal intraocular behavior, including posterior migration [4] .  \nAlthough posterior dislocation of endothelial keratoplasty grafts has been reported, such events remain extremely rare, and the majority of published cases focus primarily on graft localization and retrieval rather than secondary posterior segment complications. Herein, we report a rare case of posterior migration of a DMEK graft into the vitreous cavity associated with early localized macular proliferative changes, highlighting the importance of comprehensive posterior segment evaluation and timely multidisciplinary management.  \nCase Presentation  \nA 79-year-old male with no systemic medical history was referred for progressive visual decline and corneal edema in the right eye. His ocular history included cataract surgery, anterior uveitis treated with topical steroids, and vitrectomy for premacular membrane removal.  \nAt presentation, best-corrected visual acuity was hand movements close to the face in the right eye and 20/20 in the left eye. Slit-lamp examination showed the existence of pseudoexfoliation (PEX) syndrome, and diffuse corneal edema without inflammatory cells (Figure 1A) . The posterior chamber intraocular lens (onepiece PCIOL, in-the-bag) appeared stable. Despite difficulty in precise evaluation in retina, we could see light reflex, and optical coherence tomography (OCT) showed a regular shape without cystoid macular edema (CME) or proliferative findings in the right eye (Figure 1B) and the left eye (Figure 1C) . The intraocular pressure was 14 mmHg in the right eye and 17 mmHg in the left eye. Specular microscopy revealed an unmeasurable endothelial cell density. The patient was diagnosed with bullous keratopathy, and descemet membrane endothelial keratoplasty (DMEK) was scheduled. ","cbCaibGoZhR5f40k","https://ap.wps.com/l/cbCaibGoZhR5f40k","pdf",2016431,"English","# Introduction\n# Case Presentation\n## Preoperative evaluation and diagnosis\n## DMEK procedure and intraoperative graft loss\n## Postoperative findings and surgical management\n# Discussion","[{\"question\":\"What rare complication occurred after DMEK in this case?\",\"answer\":\"During graft manipulation, the graft was lost from the anterior chamber and later was found to have migrated posteriorly into the vitreous cavity.\"},{\"question\":\"How were the macular proliferative changes detected?\",\"answer\":\"Optical coherence tomography (OCT) two weeks postoperatively revealed macular proliferative changes without hemorrhage or peripheral ischemia.\"},{\"question\":\"What surgery ultimately confirmed and treated the problem?\",\"answer\":\"Pars plana vitrectomy revealed the DMEK graft in the vitreous cavity, associated with fibrovascular proliferation, and the graft was successfully removed.\"}]","Posterior Migration of a Descemet Membrane Endothelial Keratoplasty Graft Associated With Macular Proliferative Changes | PDF",1790709611,13]