Toxic Anterior Segment Syndrome In Dalk Interface

To describe a case of Toxic Anterior Segment Syndrome in DALK interface

The case of a female patient with Keratoconnus diagnosis and corneal scarring  who underwent Deep  Anterior Lamellar  Keratoplasty at Carlos Andrade Marín Hospital (Quito - Ecuador) is presented.

A 45 year old patient diagnosed with keratoconus underwent deep anterior lamellar keratoplasty in the right eye. Due to a microperforation during surgery, viscoelastic was used in the anterior chamber to complete the dissection of the patient’s stroma. Air was placed in the anterior chamber to prevent pseudochamber formation. After 24 hours fibrin was present at the interfase and edema in the donor cornea. The interfase was cleaned in the operating room, samples for bacterial and fungal cultures were taken and a new injection of intracemerular air and subconjunctival corticosteroid was made. 

Corneal edema was resolved with cleaning of the interface and correct adhesion of the recipient donor tissue was achieved with the injection of air into the anterior chamber.

Since it was a surgery that did not present major complications and the results of the cultures were negative, we believe that the viscoelastic residues in the interface were the cause of the acute inflammation that the patient presented, which was successfully resolved with its cleaning and corticoid treatment.