Atopic Sclerokeratitis After Deep Lamellar Keratopalsty For Keratoconus

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR366 | Type: Poster | DOI: 10.82333/ydpv-wf42

Authors: Prof. Saad Leboukhe* ¹ , Dr Mounir Relila ² , Dr ISLAM BECHAKH ³

¹Ophthalmology,Military University Hospital ,Oran ,Algeria, ²Ophthalmology,Military University Hospital of Constantine ,Constantine ,Algeria, ³Ophthalmology,Military University Hospital of Oran ,Oran ,Algeria

Purpose

To report a rare and severe case of atopic sclerokeratitis occurring after deep lamellar keratoplasty (DLK) performed for advanced keratoconus.

Setting

Military Regional University hospital of Oran

Military Regional University hospital of Constantine

Methods

A 45-year-old female patient with stage 4 keratoconus of the right eye and associated deep stromal scarring was referred to our department for keratoplasty. She underwent deep anterior lamellar keratoplasty using the Melles technique, followed by postoperative treatment with topical prednisolone acetate administered five times daily, topical fluoroquinolone eye drops four times daily, and oral vitamin C supplementation

Results

A 45-year-old female with stage 4 keratoconus underwent deep anterior lamellar keratoplasty using the Melles technique. Early postoperative recovery was uneventful, with visual acuity improving from counting fingers at 3 meters to 0.7 logMAR at three weeks. One month postoperatively, the patient—who had a history of seasonal ocular allergy—developed acute ocular pain, redness, and visual loss to counting fingers at 2 meters. Clinical findings included severe ocular surface inflammation, suture loosening, corneal edema, and large epithelial defects, leading to a diagnosis of post-keratoplasty atopic sclerokeratitis. Corticosteroid therapy resulted in partial graft clearing without further visual improvement.

Conclusions

Atopic sclerokeratitis is a rare but serious post-keratoplasty complication that remains sparsely reported in the literature, particularly among patients with keratoconus and underlying ocular allergy. Careful preoperative assessment of allergic status is essential, and monitoring serum IgE levels may aid in identifying active allergic flares. Whenever feasible, elective corneal surgery should be deferred until the allergic inflammatory phase has fully resolved, underscoring the importance of meticulous perioperative allergy control to optimize graft survival and visual outcomes.