Epithelial invasion of the anterior chamber following repeated keratoplasty

A 17-year-old man underwent five perforating keratoplasties. The first operation was due to keratoconus and the first two grafts were rejected. Five months after the second operation, the patient complained of severe ocular pains and retrocorneal and iris membranes were noted. Because of acute glaucoma, a peripheral iridectomy was performed, followed by by trabeculectomy due to persistent high pressure. After the third keratoplasty, a diagnosis of epithelial downgrowth was histopathologically established. Fourth and fifth keratoplasties were done because of corneal abscesses, this time combined with membrane peeling from the vitreous cavity. Epithelial cells were diagnosed again in histopathological examination of material removed from the vitreous. The rarity of epithelial downgrowth after surgically uncomplicated keratoplasty and the importance of the symptom of severe disabling pain are stressed.