Posterior Migration of a Descemet Membrane Endothelial Keratoplasty Graft Associated With Macular Proliferative Changes

A 79-year-old male underwent descemet membrane endothelial keratoplasty (DMEK) for bullous keratopathy. Intraoperatively, the intraocular lens (IOL) became unstable during graft manipulation, and the graft was lost from the anterior chamber. Postoperative examination failed to identify the graft. Two weeks later, optical coherence tomography (OCT) showed macular proliferative changes without hemorrhage or peripheral ischemia. Subsequent pars plana vitrectomy revealed the DMEK graft in the vitreous cavity, associated with fibrovascular proliferation. The graft was successfully removed. This case demonstrates a rare complication of DMEK and emphasizes the need for vigilance in eyes with compromised posterior capsule or zonules.