[Neovascular invasion of the endothelio-descemetic interface occurring after deep anterior lamellar keratoplasty]. / Invasion néovasculaire de l'interface endothélio-descemetique au décours d'une kératoplastie lamellaire antérieure profonde.

ABSTRACT

INTRODUCTION: The endothelio-descemetic interface (EDI) of a deep anterior lamellar keratoplasty (DALK) may become the locus of a neovascular proliferation. Bevacizumab (Avastin) is an antiangiogenic alternative available for curative treatment in deep corneal neovascularization. OBSERVATION We report the case of a 49-year-old woman who had received two arcuate relaxing incisions for high astigmatism after DALK. She developed graft rejection associated with significant neovascular stromal invasion in the EDI of the graft-host interface. Two subconjunctival injections of bevacizumab 1 month apart as well as thermocauterization of the feeding vessel were necessary and effective. No recurrence has been observed after 2 years of follow-up. DISCUSSION: Corneal neovascularization can be a cause of DALK rejection. A combination of anti-antiangiogenic and physical methods may abort graft rejection and permanently restore graft function.