Bilateral Urrets-Zavalia syndrome after uneventful Descemet membrane endothelial keratoplasty

Urrets-Zavalia syndrome (UZS) stands out as a rare yet clinically consequential complication associated with ophthalmic surgery, marked by the emergence of a fixed and dilated pupil. While it was originally described post-penetrating keratoplasty (PKP) in patients with keratoconus and its prevalence is notably higher following PKP, instances of UZS have been documented in the context of other procedures, including intraocular lens implantation, Descemet-stripping endothelial keratoplasty and Descemet membrane endothelial keratoplasty (DMEK). We report a unique case of bilateral UZS after uneventful DMEK surgeries, highlighting a rare but potential complication after DMEK.