Hyperacute stromal and endothelial rejection in therapeutic penetrating keratoplasty with residual intra-stromal crystalline deposits

Manokamna Agarwal; Bhaskar Srinivasan; Geetha Iyer; Shweta Agarwal; Sridharan Sudharshan; Jothi B Janarthanam; Rama Rajagopal

doi:10.4103/ijo.IJO_2443_21

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CASE REPORT

Year : 2022 \| Volume : 2 \| Issue : 2 \| Page : 388-390

Hyperacute stromal and endothelial rejection in therapeutic penetrating keratoplasty with residual intra-stromal crystalline deposits Manokamna Agarwal¹, Bhaskar Srinivasan¹, Geetha Iyer¹, Shweta Agarwal¹, Sridharan Sudharshan², Jothi B Janarthanam³, Rama Rajagopal¹ ¹ Department of Cornea and Refractive Surgery, Sankara Nethralaya, Medical Research Foundation, Chennai- 600 006, Tamil Nadu, India ² Department of Uvea, Sankara Nethralaya, Medical Research Foundation, Chennai- 600 006, Tamil Nadu, India ³ Department of Optometry, Sankara Nethralaya, Medical Research Foundation, Chennai- 600 006, Tamil Nadu, India Correspondence Address: Bhaskar Srinivasan Sankara Nethralaya, Medical Research Foundation, 18, College Road, Chennai - 600 006, Tamil Nadu India Source of Support: None, Conflict of Interest: None DOI: 10.4103/ijo.IJO_2443_21

Stromal rejection is rare and uncommonly seen in its pure form. We report a case of hyperacute stromal rejection followed by endothelial rejection post-therapeutic penetrating keratoplasty (PK) done for fungal keratitis. The rejection episode responded to steroids with a clearing of the graft. Residual mid to deep intra-stromal crystalline deposits remained at the area of stromal rejection, which remained stationary for a follow-up period of 1 year. The patient underwent Anterior segment optical coherence tomography (AS-OCT) to demonstrate the condition objectively.



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