Posters

Corneal hydrops in progressive Urrets–Zavalia syndrome

Poster Details

First Author: B.Issergepova KAZAKHSTAN

Co Author(s):    N. Aldasheva   G. Esenzhan   N. Sabyrbayev              

Abstract Details

Purpose:

to report 2 cases of development Urrets-Zavalia syndrome after penetrating keratoplasty in patients with corneal hydrops in anamnesis.

Setting:

Urrets-Zavalia syndrome (UZS) includes three signs: fixed dilated pupil, secondary glaucoma and iris atrophy. Frequency of occurrence of this syndrome is from 2,2 to 17,2% in different population and is more specific for the patients with keratoconus after corneal transplantation.

Methods:

There were 80 patients under observation with penetrating keratoplasty (PKP) for 2 years. All patients underwent a full ophthalmic clinical examination, including anterior segment optical coherence tomography (AS-OCT). UZS was developed of two patients with keratoconus (a 25 y.o. woman and a 24 y.o. man). Both patients had in anamnesis corneal hydrops 4-6 months before PKP. In the outcome corneal hydrops in both of cases Descemet's membrane  detachment according to AS-OCT. After or during the operation there was no evidence of using mydriatics or miotics.

Results:

The operation in all cases was uneventful. On the first day after surgery, both patients noted severe pain in the eye. Intraocular pressure in the early postoperative period was within the normal range. Dilated pupil dilation up to 6 mm in one case and up to 8 mm in another case began on the second day after surgery. Drug therapy for constriction of the pupil was ineffective. In the first case the graft remained transparent. In the second case the patient developed atrophy of the iris, secondary glaucoma, for one year after the operation the transplant was totally clouded.

Conclusions:

Corneal hydrops in the anamnesis of keratoconus patients can be considered as a risk factor for the progression of UZS. Severe pain in the first days after surgery should also alert the surgeon against the threat of the development of this syndrome. UZS significantly reduces functional outcomes of corneal transplantation. The authors do not have any financial interest.

Financial Disclosure:

None