Athalamia as a late complication after keratoplasty on aphakic eyes

In 3 cases of keratoplasty in aphakic eyes 4--8 months after surgery a gradual flattening of the anterior chamber was observed. During the initial postoperative months there was no suggestion of any impending complication. No synechiae at the anterior chamber angle were present, the anterior vitreous face had remained intact without being in contact with the posterior corneal surface, and the intraocular pressure remained within normal limits. Separation of anterior synechiae as well as vitrectomy via pars plana resulted merely in a temporary amelioration of this condition. Within a few days the anterior chamber was abolished again. The corneal buttons displayed epithelial oedema; the deeper layers, however, remained clear. Development of secondary glaucoma was kept under control either by appropriate medication or by cyclocryotherapy. The phenomenon reported here developed only in cases in which the anterior vitreous face had remained intact. It seems possible that this type of late complication may be avoided by prophylactic vitrectomy.