A 32 year-old male operated for keratoconus and a 19 year-old female operated for granular dystrophy experienced fixed dilated pupillae and intraocular pressure rise following deep anterior lamellar keratoplasty surgery complicated with Descemet membrane perforation and converted to penetrating keratoplasty. Both were treated to lower the intraocular pressure and to save the grafts with satisfactory visual acuity, however fixed dilated pupillae did not resolve.

In conclusion, all patients who underwent corneal transplant should be closely monitored postoperatively in order to timely diagnose Urretz Zavalia syndrome. Appropriate treatment may decrease the risk of sequels in this situation. Keywords : Deep anterior lamellar keratoplasty, fixed dilated pupillae, glaucoma, penetrating keratoplasty, Urretz-Zavalia syndrome