Spontaneous Artificial Corneal Endothelial Graft Reattachment: Case Report

Cornea. 2025 Dec 1;44(12):1546-1550. doi: 10.1097/ICO.0000000000003905. Epub 2025 Jun 3.

Abstract

Purpose: EndoArt, a synthetic endothelial substitute for corneal edema, often requires multiple rebubbling procedures because of high detachment rates. This study reports 2 cases of spontaneous EndoArt reattachment, suggesting a potential alternative management approach.

Methods: Two patients with endothelial dysfunction underwent EndoArt implantation. Both experienced partial detachment postoperatively. Although rebubbling was considered, a conservative approach was taken, leading to spontaneous reattachment. Serial anterior segment optical coherence tomography (AS-OCT) monitored graft adherence and corneal thickness.

Results: Spontaneous reattachment occurred within 2 to 6 weeks, accompanied by progressive corneal thinning and clarity improvement. No further intervention was required, and reattachment remained stable for 6 to 8 months. These cases challenge the notion that all EndoArt detachments necessitate immediate rebubbling.

Conclusions: This is the first report of spontaneous EndoArt reattachment. Although rebubbling remains standard practice, observation may be a viable option in select cases, reducing the need for additional procedures. Further studies are needed to refine management strategies and improve outcomes.

Keywords: EndoArt; artificial endothelial graft; bullous keratopathy; endothelial dysfunction.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Corneal Edema* / surgery
  • Endothelium, Corneal* / transplantation
  • Female
  • Graft Survival* / physiology
  • Humans
  • Male
  • Middle Aged
  • Tomography, Optical Coherence
  • Visual Acuity / physiology