Acute Comitant Esotropia Following Penetrating Keratoplasty

Purpose: to report a case of acute comitant esotropia in a patient with bilateral keratoconuspresenting after penetrating keratoplasty (pkp) in the fellow eye.case report: a 17-year-old male patient with bilateral keratoconus underwent pkp inhis right eye. he experienced diplopia after removal of the patch from the operated eye12 hour postoperatively due to esotropia in his left (unoperated) eye. diplopia wascontrolled using prism glasses and botulinum toxin a injections until pkp wasperformed in his left eye which resulted in restoration of stable fusion up to 3 years offollow up.conclusion: acute comitant esotropia may occur after loss of fusion due to ocularpatching in a vulnerable patient. in this patient fusion was preserved with non-surgicalmethods until it was restored by surgical means.