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Secondary Corneal Myxoma After DMEK (Descemet Membrane Endothelial Keratoplasty)

Dimitri Chaussard, Eric Frouin, Julie Francois, Maxime Sot, Elena-Adinisia Paraschiv, Jean-Marc Perone

(Department of Ophthalmology, Regional Hospital Center of Metz-Thionville Mercy Hospital, Metz, France)

Am J Case Rep 2019; 20:1350-1355

DOI: 10.12659/AJCR.917641

BACKGROUND: This is a clinical case of secondary corneal myxoma, which developed 18 months after Descemet membrane endothelial keratoplasty (DMEK). The DMEK was performed to treat viral endotheliitis and, postoperatively, a diagnosis of Crohn’s disease was made.
CASE REPORT: A 52-year-old male, with no prior clinical history, presented with an endotheliitis in the left eye. The hypothesis of an undetected herpes infection was favored, and an antiviral treatment was prescribed using valacyclovir (1 g orally, 3 times daily). After 3 months of antiviral treatment, the endotheliitis was successfully controlled and a combined intervention of DMEK endothelial graft and phacoemulsification was performed. A corneal tumor was found 18 months after a successful DMEK procedure and was surgically removed. A pathological examination revealed a secondary corneal myxoma.
CONCLUSIONS: Corneal myxomas are rare lesions, often secondary to trauma in the Bowman’s membrane, which is why it is often called a myxomatous corneal degeneration. In this instance, there is no link with Carney complex. However, myxomas under the eyelid or within the orbit are often associated with cardiac myxomas. Treatment is strictly surgical, either by simple excision or by surgical excision followed by graft. To the best of our knowledge, this is the first time that such an association between DMEK and secondary corneal myxoma has been described in the literature.

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