{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:53:49Z","timestamp":1760144029638,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Santen SA"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Traumatic injuries in eyes previously treated with Deep Anterior Lamellar Keratoplasty (DALK) can lead to ruptures in the Descemet Membrane (DM) and damage to the corneal endothelium, a crucial layer for maintaining corneal clarity. Due to cell cycle constraints, the human corneal endothelium cannot proliferate; instead, it compensates for injury through cell enlargement and migration from adjacent areas. Methods: This study examines a notable case of corneal endothelial cell migration following a penetrating eye injury in a patient previously treated with DALK for keratoconus, supplemented by a review of relevant literature to contextualize the regenerative response. Results: A 39-year-old male with a history of DALK suffered a traumatic eye injury, resulting in damage to the Descemet Membrane and loss of the crystalline lens. After primary repair and considerations for further surgery, the patient\u2019s cornea cleared remarkably, with an improved visual acuity. This demonstrates the DM\u2019s potential for self-repair through endothelial cell migration. Conclusions: The outcomes suggest that delaying corneal transplant surgery for up to 3 months following Descemet Membrane injury due to ocular trauma could be advantageous. Allowing time for natural healing processes might eliminate the need for further invasive surgeries, thereby improving patient recovery outcomes.<\/jats:p>","DOI":"10.3390\/jcm13051424","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T08:13:44Z","timestamp":1709194424000},"page":"1424","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endothelial Migration and Regeneration after Penetrating Trauma Injury in a Deep Anterior Lamellar Keratoplasty Graft: Case Presentation and Literature Overview"],"prefix":"10.3390","volume":"13","author":[{"given":"Luca","family":"Pagano","sequence":"first","affiliation":[{"name":"Department of Corneal Diseases, St. Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK"},{"name":"IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Borgia","sequence":"additional","affiliation":[{"name":"Department of Corneal Diseases, St. Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK"},{"name":"Eye Unit, Humanitas-Gradenigo Hospital, 10153 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadi","family":"Alfaqawi","sequence":"additional","affiliation":[{"name":"Department of Corneal Diseases, St. Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aruni","family":"Makuloluwa","sequence":"additional","affiliation":[{"name":"Department of Corneal Diseases, St. Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-6366","authenticated-orcid":false,"given":"Giulia","family":"Coco","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-0289","authenticated-orcid":false,"given":"Giuseppe","family":"Giannaccare","sequence":"additional","affiliation":[{"name":"Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Messina","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, 61029 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vito","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Corneal Diseases, St. Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK"},{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, 25121 Brescia, Italy"},{"name":"Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunal","family":"Gadhvi","sequence":"additional","affiliation":[{"name":"Department of Corneal Diseases, St. Paul\u2019s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8YE, UK"},{"name":"Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.2147\/OPTH.S227631","article-title":"Comparative Evaluation of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery","volume":"13","author":"Stevenson","year":"2019","journal-title":"Clin. Ophthalmol."},{"key":"ref_2","first-page":"2670","article-title":"Comparison of the Characteristics and Outcomes of Traumatic Wound Dehiscence after Penetrating or Lamellar Keratoplasty for Keratoconus","volume":"32","author":"AlDhaheri","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.ophtha.2010.11.002","article-title":"Deep Anterior Lamellar Keratoplasty as an Alternative to Penetrating Keratoplasty: A Report by the American Academy of Ophthalmology","volume":"118","author":"Reinhart","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"631409","DOI":"10.1155\/2015\/631409","article-title":"Traumatic Wound Dehiscence after Keratoplasty: Characteristics, Risk Factors, and Visual Outcome","volume":"2015","author":"Goweida","year":"2015","journal-title":"J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s10384-012-0197-5","article-title":"Corneal Biomechanical Properties in Eyes with No Previous Surgery, with Previous Penetrating Keratoplasty and with Deep Anterior Lamellar Keratoplasty","volume":"57","author":"Acar","year":"2013","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1136\/bjophthalmol-2015-307604","article-title":"Incidence, Severity and Outcomes of Traumatic Wound Dehiscence Following Penetrating and Deep Anterior Lamellar Keratoplasty","volume":"100","author":"Meyer","year":"2016","journal-title":"Br. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1016\/j.ophtha.2009.04.047","article-title":"Characteristics of Traumatic Globe Rupture after Keratoplasty","volume":"116","author":"Kawashima","year":"2009","journal-title":"Ophthalmology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1167\/iovs.15-18300","article-title":"Predicative Factors for Corneal Endothelial Cell Migration","volume":"57","author":"Soh","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6983","DOI":"10.1038\/s41598-017-07557-2","article-title":"Descemet\u2019s Membrane Supports Corneal Endothelial Cell Regeneration in Rabbits","volume":"7","author":"Chen","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2013.01.003","article-title":"Corneal Endothelial Regeneration and Tissue Engineering","volume":"35","author":"Mimura","year":"2013","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1167\/iovs.05-1223","article-title":"FGF-2-Induced Wound Healing in Corneal Endothelial Cells Requires Cdc42 Activation and Rho Inactivation through the Phosphatidylinositol 3-Kinase Pathway","volume":"47","author":"Jeong","year":"2006","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_12","first-page":"1816","article-title":"In Vitro Pharmacologic Separation of Corneal Endothelial Migration and Spreading Responses","volume":"31","author":"Joyce","year":"1990","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"III","DOI":"10.1016\/S0079-6336(11)80033-1","article-title":"Cytological and Immunocytochemical Approaches to the Study of Corneal Endothelial Wound Repair","volume":"28","author":"Gordon","year":"1994","journal-title":"Prog. Histochem. Cytochem."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/S0886-3350(02)01984-3","article-title":"Corneal Edema Resolution after \u201cDescemetorhexis\u201d","volume":"29","author":"Braunstein","year":"2003","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1111\/j.1442-9071.2006.01319.x","article-title":"Spontaneous Resolution of Corneal Oedema Following Descemet\u2019s Detachment","volume":"34","author":"Watson","year":"2006","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Choi, S.O., Jeon, H.S., Hyon, J.Y., Oh, Y.J., Wee, W.R., Chung, T.Y., Shin, Y.J., and Kim, J.W. (2015). Recovery of Corneal Endothelial Cells from Periphery after Injury. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0138076"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.trsl.2022.05.003","article-title":"Corneal Endothelial Wound Healing: Understanding the Regenerative Capacity of the Innermost Layer of the Cornea","volume":"248","author":"Vercammen","year":"2022","journal-title":"Transl. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jcjo.2014.10.014","article-title":"Descemetorhexis for Fuchs\u2019 Dystrophy","volume":"50","author":"Moloney","year":"2015","journal-title":"Can. J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.exer.2011.08.014","article-title":"Proliferative Capacity of Corneal Endothelial Cells","volume":"95","author":"Joyce","year":"2012","journal-title":"Exp. Eye Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1167\/iovs.04-1263","article-title":"Human Corneal Endothelial Cell Precursors Isolated by Sphere-Forming Assay","volume":"46","author":"Yokoo","year":"2005","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_21","first-page":"bcr-2017-221495","article-title":"Rescuing the Host Descemet\u2019s Membrane in Full-Thickness Traumatic Wound Dehiscence in Deep Anterior Lamellar Keratoplasty: Intraoperative Optical Coherence Tomography (IOCT)-Guided Technique","volume":"2017","author":"Chaniyara","year":"2017","journal-title":"Case Rep."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1424\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:07:15Z","timestamp":1760105235000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1424"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,29]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jcm13051424"],"URL":"https:\/\/doi.org\/10.3390\/jcm13051424","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2024,2,29]]}}}