Pathogenesis of Fixed Dilated Pupil (Urrets-Zavalía Syndrome) after Deep Lamellar Keratoplasty in Keratoconus

Abstract

Purpose To present a case series of patients that developed Urrets-Zavalia syndrome (UZS) after deep anterior lamellar keratoplasty (DALK) for treating keratoconus and discuss the mechanisms for the syndrome. Materials and methods Retrospective chart analysis of patients who developed UZS after DALK at the Cornea Unit, Hospital São Geraldo, Federal University of Minas Gerais. Results We present a series of 3 patients with features consistent with UZS, after undergoing DALK. Elevated intraocular pressure (IOP) was noted in the early postoperative period in 2 cases, despite the fact that the other case reported eye pain, headache, and nausea at the night after the surgery with undocumented IOP. Although at different extents, the pupil remained atrophic and dilated in all 3 eyes, and 2 of them developed anterior subcapsular cataract. Conclusion Iris ischemia resulting from occlusion of iris root vessels due to elevated IOP higher than diastolic blood pressure causes UZS. Elevated IOP should be monitored, especially in young patients with low diastolic blood pressure, in order to avoid the occurrence of the syndrome. How to cite this article Reis JRC, Diniz-Filho A, Rocha FM, Torquetti L. Pathogenesis of Fixed Dilated Pupil (Urrets-Zavalía Syndrome) after Deep Lamellar Keratoplasty in Keratoconus. Int J Kerat Ect Cor Dis 2016;5(1):32-34.