Abstract Form

Title: Stromal graft rejection after uneventful Deep Anterior Lamellar Keratoplasty that mimics endothelial rejection
Author(s): Reza Soltani-Moghadam, M.D. Associate Professor of Ophthalmology-Mitra Akbari, M.D. Assistant Professor of Ophthalmology (Corresponding Author)
Presentation Type: Poster
Subject: Cornea and Refractive
Others:
Presenting Author:
Name: Mitra Akbari
Affiliation :(optional) Eye Research Center, Department of Ophthalmology, Guilan University of Medical Sciences
E mail: mitra.akbari20@gmail.com
Phone: 01333238307
Mobile: 09113362179
Abstract (Max 200 words)
Purpose: To describe the clinical features, management, and visual outcome in a case of stromal rejection with a rare and unusual presentation after deep anterior lamellar keratoplasty (DALK).
Methods: case report
Results: A 25-year-old healthy man with advanced keratoconus underwent DALK using the standard big bubble technique in his right eye. Five months after surgery, the patient involved in red eye, decreased vision, acute epithelial edema, acute and diffuse stromal edema, fine diffuse keratic precipitates (KPs) in the graft location and AC inflammation with cells and flair without any vascularization in the graft and recipient bed, and any infiltration or loosening of the sutures. Management with topical and systemic steroids, and topical antibiotic lead to complete resolution of stromal edema, KPs and AC inflammation. Nine months after the first episode, the patient was referred due to the same clinical presentation and similar finding on examination. Recurrence was treated successfully with the same prior medications and clear graft was achieved.
Conclusion: Although there is no endothelial immune reaction after DALK for keratoconus, stromal graft rejection after DALK can be presented with same features as endothelial graft rejection.
Attachment: 1026case 2.pptx