Epithelial Ingrowth Post Dalk

Epithelium ingrowth is a rare but significant complication following deep anterior lamellar keratoplasty (DALK). This case report highlights a patient who developed epithelial ingrowth postoperatively, leading to visual impairment. The objective is to discuss the management strategy to restore visual outcome of patient.

Hazem Yassin Cornea center specializing in corneal transplantation procedures. The case involves a 37-year-old female with advanced keratoconus who underwent DALK surgery October 2024 the surgery was uneventful one month later developed epithelial ingrowth.

A 37-year-old female advanced keratoconus in the left eye, Unaided visual acuity CF 100 cm not improving, corneal topography was done showed K-reading K1 66.3 / K2 69 and CCT 367, October 2024 underwent a successful DALK procedure the surgery was uneventful, first postoperative examination graft was clear, sutures good, one month follow-up the patient reported decreased visual acuity and photophobia. Slit-lamp examination revealed epithelial cells infiltrating the graft-host interface with mild interface haze, anterior segment optical coherence tomography (AS-OCT) was done showed epithelial ingrowth in the interface between the donor and recipient corneal, Treatment involved surgical debridement of the ingrowth, the patient was monitored closely for signs of recurrence. Visual acuity improved post-operative, and no further ingrowth was observed.

Epithelium ingrowth post-DALK is a rare but potentially vision-threatening complication. Early detection and timely intervention, including surgical debridement and wound closure, are crucial. Proper intraoperative precautions and postoperative monitoring can improve patient outcomes.