Nonimmunologic graft failure after Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) for presumed amantadine-induced corneal edema. Eye Contact Lens 2009 Jul;35(4):209-11
Date
06/12/2009Pubmed ID
19516146DOI
10.1097/ICL.0b013e3181a6936fScopus ID
2-s2.0-68849122989 (requires institutional sign-in at Scopus site) 12 CitationsAbstract
CONTEXT: With one exception, a case report of amantadine-induced corneal toxicity has described reversible corneal edema.
OBJECTIVE: To report a patient with unrecognized amantadine-induced corneal edema.
DESIGN: Patient with schizophrenia and tardive dyskinesia developed bilateral corneal edema while receiving chronic amantadine hydrochloride. Both eyes underwent successful phakic Descemet's stripping automated endothelial keratoplasty, and histopathologic examination of the excised host tissue was performed.
RESULTS: Despite initial clearing of the donor lenticules, both eyes later experienced nonimmunologic graft failure, probably related to continued amantadine corneal toxicity. After discontinuation of the amantadine, one graft demonstrated partial clearing. Histopathology demonstrated endothelial cell loss. Specular microscopy demonstrated pleomorphism and disruption of the orderly hexagonal array.
CONCLUSIONS: Chronic amantadine hydrochloride therapy may be responsible for irreversible corneal edema and may lead to graft failure in unrecognized cases.
Author List
Koenig SB, McDermott ML, Simons KBMESH terms used to index this publication - Major topics in bold
AdultAmantadine
Automation
Corneal Edema
Corneal Transplantation
Descemet Membrane
Drug Administration Schedule
Endothelium, Corneal
Female
Humans
Reoperation
Treatment Failure
