Case ReportFeatures of Urrets-Zavalia Syndrome After Descemet Stripping Automated Endothelial KeratoplastyAnwar, Didar S. MD; Chu, Claire Y. MD; Prasher, Pawan MD; Bowman, Robert W. MD; Mootha, V. Vinod MDAuthor Information Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX. Reprints: V. Vinod Mootha, Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9057 (e-mail: [email protected]). Supported by Unrestricted Department Grant from Research to Prevent Blindness, New York, NY. Presented in part at the Annual Meeting of ASCRS; April 2008; Chicago, IL. The authors have no conflicts of interest to disclose. Received May 10, 2011 Accepted April 8, 2012 Cornea: November 2012 - Volume 31 - Issue 11 - p 1330-1334 doi: 10.1097/ICO.0b013e318259ca15 Buy Metrics Abstract Purpose: To report a case series of pupil abnormalities consistent with features of Urrets-Zavalia syndrome (UZS) after Descemet stripping automated endothelial keratoplasty (DSAEK) for corneal edema secondary to corneal endothelial cell dysfunction. Methods: Retrospective chart analysis of subjects who developed UZS after DSAEK at the University of Texas Southwestern Medical Center. Results: We present a series of 7 eyes with features consistent with UZS, after undergoing DSAEK. Elevated intraocular pressures (IOP) were noted in the early postoperative period in all cases. Five of 7 had graft dislocation in the postoperative period and required rebubbling or repeat DSAEK to obtain a well-apposed graft. Patients were followed for 3 to 14 months and showed improvement in visual acuity and IOP, but fixed dilated pupils persisted. Conclusion: A fixed irregular or dilated pupil is a rare complication that can be associated with DSAEK surgery. Patients with an elevated IOP and complicated postoperative course seem to be at greater risk for developing iris ischemia and pupil abnormalities consistent with the diagnosis of UZS. © 2012 Lippincott Williams & Wilkins, Inc.