Gentian violet (GV) ink associated reaction in a case of preloaded Descemet membrane endothelial keratoplasty: Case report

Abstract

Purpose: This report describes a case of Descemet membrane endothelial keratoplasty (DMEK) graft failure after non-clearing bullae over the area of the orientation mark on the graft. Methods: Case report. Results: The summary of the clinical presentation and workup is described, followed by a brief overview of the DMEK procedure and the gentian violet (GV) ink used to ensure the correct orientation of the DMEK graft. Conclusions: GV has a good safety profile; however, there are rare cases of adverse events. Therefore, alternative approaches should be explored, such as the use of intraoperative optical coherence tomography, reviewing a video recording of the insertion step, adjusting the insertion technique, or using asymmetrical trephine marking on graft edges.

Keywords

• Keratoplasty
• Gentian violet
• Endothelial dysfunction
• Graft failure
• Graft rejection