Fixed dilated pupil (Urret-Zavalia yndrome) after air/ga injection after deep lamellar keratoplaty for keratoconu

PURPOE: To decribe three cae of fixed dilated pupil and preumed iri ichemia (Urret-Zavalia yndrome) after anterior chamber air/ga injection after deep lamellar keratoplaty for keratoconu. METHOD: Interventional cae erie. Three eye of three patient with keratoconu underwent deep lamellar keratoplaty and intraoperative or potoperative injection of air/ga in the anterior chamber to appoe the hot-donor lamellar graft interface. REULT: Urret-Zavalia yndrome wa diagnoed on clinical ground in three cae and wa aociated with the Decemet membrane microperforation intraoperatively and introduction of air/ga into the anterior chamber intraoperatively or potoperatively. CONCLUION: A fixed dilated pupil i an uncommon complication of penetrating keratoplaty for keratoconu that can alo develop after deep lamellar keratoplaty. Leaving an air or ga bubble in the anterior chamber of a phakic eye after deep lamellar keratoplaty i a rik factor and hould therefore be avoided.