Rescuing the host Descemets membrane in full-thickness traumatic wound dehiscence in deep anterior lamellar keratoplasty: intraoperative optical coherence tomography (iOCT)-guided technique

Optimal visual recovery following full-thickness traumatic wound dehiscence in a case of operated deep anterior lamellar keratoplasty (DALK) is rarely seen. Here we report a case of 22-year-old male patient presented to our casualty department with complaint of sudden-onset diminution of vision in his right eye following blunt trauma of 1 day duration. DALK had been performed 11 months ago for advanced keratoconus in the same eye. Best-corrected visual acuity (BCVA) in the right eye was hand movement close to face with accurate projection of rays and in the left eye was 20/20. Slit-lamp examination showed the presence of inferior 180° graft dehiscence with broken sutures and shallow anterior chamber with corneal oedema. Repair of the dehiscence with descemetopexy was done under the guidance of intraoperative optical coherence tomography with the successful rescuing of the host Descemet's membrane. BCVA at 6 months follow-up was 20/40.

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