Triple Descemet membrane endothelial keratoplasty for Haab striae with endothelial decompensation in congenital glaucoma

We report a case of congenital strabismus and glaucoma associated with severe Haab striae, endothelial decompensation, and corticonuclear cataract that was treated successfully with Descemet membrane endothelial keratoplasty (DMEK) combined with phacoemulsification and posterior chamber intraocular lens implantation (triple DMEK). In this case, a 60-year-old woman presented with progressive decreased visual acuity and increased cloudiness, especially in the morning, in both eyes (left > right). She had goniotomy and strabismus surgery in 1957 when she was 6 months old. Six months after the triple DMEK procedure was performed in the left eye, the corrected distance visual acuity was 20/40, the intraocular pressure was 14 mm Hg, and the central corneal thickness was 452 μm. Slitlamp biomicroscopy showed a clear cornea with no signs of graft rejection. In conclusion, severe Haab striae caused by long-standing congenital glaucoma can be treated successfully with the new triple DMEK procedure.