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First Author: V.Jovanovic SERBIA
Co Author(s): L. Nikolic S. Delevic M. Jankov
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To report a patient with an unusually high endothelial cell loss after an anterior lamellar graft rejection.
Faculty of Medical Dentistry, University of Belgrade, Serbia
corneal topography, surgery, confocal microscopy.
A 37-year-old man with 2607 endothelial cells per mm2 +/-SD 19 underwent deep anterior lamellar keratoplasty (DALK) for keratoconus. At 12 months follow- up graft remained clear with 2347 endothelial cells per mm2 +/-SD 19. Fourteen months after the surgery, the patient presented with stromal and epithelial edema with small bullae in the graft. Corneal vascularization and infiltrates were absent. After the rejection reversal, endothelial cell density was 1449 cells per mm2 +/- SD 19.
A late stromal rejection could cause most of the 38 % loss of endothelial cells and an acute endothelial dysfunction with epithelial edema and bullae formation.