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Updated: Apr 18, 2026
Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts
Published on: October 21, 2022
Stromal graft rejection after deep anterior lamellar keratoplasty at a tertiary care center
Khalid S Almousa1,2, Majed S Alkharashi1
1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Purpose:
To evaluate the characteristics and outcomes of stromal rejection after deep anterior lamellar keratoplasty (DALK) at a tertiary care center in Saudi Arabia.
Methods:
The clinical records of 42 patients who underwent DALK between January 2019 and December 2023 were reviewed to identify patients who had experienced stromal rejection. Those patients were analyzed in terms of biodata, indications for surgery, graft size, subjective and objective clinical findings, treatment courses, and follow-ups.
Results:
Of the 42 cases of DALK conducted during the study in our center, 3 (7.1%) experienced graft rejection between postoperative months 8 and 18. The mean age of patients with rejection at presentation was 30.6 years, compared to 33.5 years for those without rejection. The mean follow-up durations were 16.6 months for patients with rejection and 25.7 months for patients without rejection. All patients started intensive topical prednisolone acetate 1% (half hourly to hourly) on first presentation, and one had a pulse of intravenous methylprednisolone. A complete recovery was observed in all patients after 1-2 weeks.
Conclusion:
While DALK offers significant advantages over full-thickness corneal grafting, graft rejection remains a potential complication. Early presentation and timely treatment of rejection after DALK carry a good prognosis and can prevent graft failure.
