Case report reveals complete excision and repeat keratoplasty restored vision in a post-transplant retrocorneal membrane, suggesting early imaging and removal prevent recurrence.
Purpose: To describe a case of retrocorneal membrane (RCM) after penetrating keratoplasty (PKP) and to discuss its diagnostic and therapeutic approach. Methods: Case report and review of the literature. Results: An 80-year-old woman, pseudophakic in both eyes, underwent PKP in the left eye (OS) 2 years prior for pseudophakic bullous keratopathy. She presented to our clinic with progressive visual decline (BCVA 20/400 OS). Slit-lamp examination revealed a dense retrocorneal opacity with stromal edema and normal intraocular pressure (18 mm Hg). AS-OCT confirmed a hyperreflective membrane posterior to the corneal graft (central pachymetry 604 μm); endothelial cell count was 490 cells/mm 2 . Surgical management consisted of repeat PKP (re-PKP) with viscodissection and manual removal of the elastic, adherent membrane using Colibri forceps. Histopathology revealed a fibrocellular proliferation positive for α-SMA and vimentin, negative for CK7, consistent with endothelial–mesenchymal transformation. At 48-month follow-up, the graft remained clear with BCVA 20/40 and no recurrence. Conclusions: Retrocorneal membrane is an uncommon but vision-threatening complication after PKP. Prompt recognition by slit-lamp and AS-OCT, combined with complete surgical excision, may restore transparency and prevent recurrence.
No takes yet. Share an insight, caveat, or question.
Larco et al. (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: