Detachment of Descemet's membrane from grafts following wound separation: light and scanning electron microscopic study.

Examination of 4 specimens of failed grafts following wound rupture shows that separation of Descement's membrane from the periphery of the graft in the area of dehiscence is followed by morphological changes in endotelial cells and by the development of fibrous membranes. Defective wound healing after repair is probably caused by persistent edema of graft stroma. With sudden decompression of the globe, rupture and total detachment of Descemet's membrane may occur. Changes in Descemet's membrane and eventual failure of the graft may occur mostly on the basis of anatomical changes in the endothelium of the graft and not necessarily by inflammation which was not present in these 4 specimens.