title: [Neovascular invasion of the endothelio-descemetic interface occurring after deep anterior lamellar keratoplasty].
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service d'ophtalmologie, Centre national de référence du kératocône, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. loic.pinsard@gmail.com
authors.forename: L
authors.initials: L
authors.lastname: Pinsard
authors.forename: F
authors.initials: F
authors.lastname: Malet
authors.forename: J
authors.initials: J
authors.lastname: Colin
authors.forename: D
authors.initials: D
authors.lastname: Touboul
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use; D001251:Astigmatism / Q000188:drug therapy / Q000601:surgery; D000068258:Bevacizumab; D003316:Corneal Diseases / Q000188:drug therapy / Q000601:surgery; D016510:Corneal Neovascularization / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016039:Corneal Transplantation / Q000009:adverse effects* / Q000379:methods; D003886:Descemet Membrane / Q000098:blood supply* / Q000473:pathology; D004728:Endothelium, Corneal / Q000098:blood supply* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab