A 30-year-old female, who underwent Deep Anterior Lamellar Keratoplasty (DALK) along with an amniotic membrane transplant and allo-SLET in her right eye (OD) for chemical injury 2 years ago presented with progressive diminution of vision. Slit-lamp examination (SLE) revealed a large DALK graft with dense posterior sub-capsular cataract. Patient was scheduled for phacoemulsification with foldable intraocular lens implantation which was extremely challenging due to poor visualization. Postoperatively graft edema with interface separation, probably related to side-port wound hydration was noted in Anterior segment optical coherence tomography (ASOCT) and managed with intracameral air injection and compression sutures. At 2 weeks postoperative period graft edema had resolved and vision improved to 6/24; N18. This case highlights a rare instance of iatrogenic host-bed dehiscence with a favourable visual outcome.
Bhargava et al. (Wed,) studied this question.