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Updated: Aug 19, 2026
Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts
Published on: October 21, 2022
Presumed stromal graft rejection after deep anterior lamellar keratoplasty
Abdullah Al-Torbak1, Mohammad Malak, Klaus D Teichmann
1Anterior Segment Division, Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. atorbaq@health.net.sa
Purpose:
To demonstrate the development of presumed immune-mediated stromal rejection after deep anterior lamellar keratoplasty and its reversal after initiation of intensive topical corticosteroid therapy.
Methods:
Observational case report carried out with the approval of the hospital institutional review board.
Results:
Stromal edema and peripheral vascularization developed 16 months after deep anterior lamellar keratoplasty for keratoconus in a 13-year-old girl. After 2 weeks of intensive topical corticosteroids, complete reversal of stromal edema and regression of peripheral vascularization occurred, with full recovery of visual function.
Conclusion:
The clinical appearance and response to therapy in this case support the diagnosis of immune-mediated stromal rejection. Ophthalmologists should be aware that sight-threatening stromal rejection may occur in lamellar corneal grafts.
