Acute Hydrops After Deep Anterior Lamellar Keratoplasty in a Patient With Keratoconus

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Purpose:To report the occurrence of acute hydrops 52 months after successful deep anterior lamellar keratoplasty (DALK) using the Anwar big-bubble technique in a keratoconic eye.Methods:A 20-year-old man with a history of bilateral keratoconus who had undergone DALK in his right eye, presented with complaints of sudden visual reduction, photophobia, redness, and pain in the same eye.Results:Review of his clinical course, slit-lamp biomicroscopy, and laboratory evaluation, including ultrasound biomicroscopy, revealed acute hydrops in the graft. He was medicated with hypertonic solutions but because of persistent graft edema and nonattached Descemet membrane, penetrating keratoplasty was performed. Histopathologic examination confirmed the diagnosis.Conclusions:Similar to penetrating keratoplasty, acute hydrops can occur after DALK using the big-bubble technique in patients with keratoconus.

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