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Triple anterior chamber after deep anterior lamellar keratoplasty

Poster Details

First Author: S.Acar TURKEY

Co Author(s):    B. Torun Acar              

Abstract Details


To report a case of triple anterior chamber development and treatment after deep anterior lamellar keratoplasty (DALK).


Universal Hospital, Ophthalmology Department, Istanbul, Turkey


A 30-year-old male with granular dystrophy underwent DALK in his right eye. His visual acuity was 20/200 prior to surgery. The operation began with Anwar's 'big bubble technique', but continued with lamellar dissection as a big bubble was not formed. Inferior micro perforation occurred during surgery. Viscoelastic was injected into the anterior chamber in order to create sufficient tonus. Air was injected into the anterior chamber at the end of the operation.


On the first post-operative day, we observed a triple anterior chamber using slit lamp biomicroscopy, and it was clearly demonstrated with OCT. We suspected a viscoelastic leftover at the interface; therefore, on the second post-operative week, we removed the sutures, washed the space between the graft and recipient bed, re-sutured, and injected air into the anterior chamber. Six months after DALK, the detachment was resolved, and a relieved Descemet's membrane was demonstrated by OCT. At the same time, the graft was clear and the best corrected visual acuity was 20/32 in the right eye.


Micro perforation occurred during surgery and it was developed in the anterior chamber by causing the disintegration of the recipient bed with detachment of the Descemet's membrane. The double/triple anterior chamber treatment due to the leakage of viscoelastic through microperferation cannot be taken in control with air/gas injection. The surgical intervention is unconditionally necessary because the viscoelastic must be completely removed by irrigating. FINANCIAL INTEREST: NONE

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