Anterior segment OCT-based diagnosis and management of retained Descemet's membrane following penetrating keratoplasty.

Purpose: To report a case of retained Descemet's membrane after penetrating keratoplasty for congenital hereditary endothelial dystrophy (CHED) documented by anterior segment optical coherence tomography and review of literature.

Methods: Case report and review of literature.

Results: A 14-year-old boy underwent penetrating keratoplasty for CHED. A retained host Descemet's membrane was detected with a supernumerary anterior chamber on the first postoperative day. The retained Descemet's membrane was documented using slit lamp adapted anterior segment optical coherence tomography (SLOCT). Surgical intervention for the Descemet's membrane removal was done in the third postoperative week. The complete removal of the membrane was confirmed on SLOCT.

Conclusion: Inadvertent retention of the host Descemet's membrane is a rare but possible complication in penetrating keratoplasty for CHED. Proper anticipation, early detection and removal will help in preventing any undue risk of graft failure.