Purpose: To report the recurrence of keratoconus 49 months after deep anterior lamellar keratoplasty (DALK).
Case report: A 21-year-old man with history of bilateral keratoconus who had undergone DALK in his right eye, presented with gradual visual loss 49 months after corneal transplantation. Slit lamp biomicroscopy revealed graft ectasia together with Vogt's striae in the posterior stroma and corneal topography demonstrated inferior steepening. With a diagnosis of recurrent keratoconus in the graft, the patient underwent penetrating keratoplasty (PK) and histopathological examination confirmed the diagnosis of keratoconus in the graft.
Conclusion: Similar to PK, keratoconus can recur in the transplanted cornea after DALK. However, the time interval from transplantation to recurrence seems to be much shorter in DALK grafts.
Keywords: Deep Anterior Lamellar Keratoplasty; Keratoconus; Recurrent Keratoconus.