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Stromal rejection following deep anterior lamellar keratoplasty: incidence and risk factors

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Session Details

Session Title: Presented Poster Session: Cornea I

Venue: Poster Village: Pod 3

First Author: : S.Tolees SAUDI ARABIA

Co Author(s): :    A. Eldanasoury              

Abstract Details


To better characterize and analyze risk factors of stromal rejection in the context of deep anterior lamellar keratoplasty (DALK).


Magrabi Eye Hospital Jeddah , Saudi Arabia


We conducted a retrospective analysis of the patients who underwent DALK in corneal unit in Magrabi eye hospital to identify patients who experienced stromal rejection. The diagnosis was made after the demonstration of acute stromal edema and/or stromal neovascularization in the absence of confounding preoperative conditions, such as herpetic keratitis.


Out of 866 eligible eyes had DALK surgery, 31 eyes of 29 patients experienced stromal rejection (3.57%). 74.19% of attacks occurred within the 32 months from surgery. 54% had DALK with Big Bubble technique. 54.83 % of cases had DALK surgery in the contralateral eye. 9 eyes (29%) had developed repeated attacks of loose sutures. In all cases postoperative corticosteroid medication was stopped. All cases treated with hourly prednisolone acetate 1% and attacks resolved except one cases which responded with Loteprednol.


The incidence of stromal rejection in DALK is clinically significant, suggesting that these patients may benefit from corticosteroid regimens like those used in penetrating keratoplasty especially if the contralateral eye had keratoplasty.

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