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We have read with interest the recently published article by Al Arrayedh H, Collum L, Murphy CC (1). The authors concluded that a poor outcome was seen after PKP for CHED in Irish population, which arises from a combination of dense amblyopia and a high risk of graft failure in the long term. This is an important study which has a unique cohort of only autosomal recessive cases from a large Irish consanguineous family.
We want to highlight some points in this article that were not clearly described .
Author reported 2 previously diagnosed congenital glaucoma cases, which also affects the visual outcome of the surgery and may skew results of this study. But they had not mentioned clearly about this.
In the figure 2 , the failed DSEK case also received regrafting twice but that was not shown in the legend.Also 32 eyes received penetrating keratoplasty as per the text but in that figure , 33 was mentioned.
In some previous studies 12 years of age (2,3) has been mentioned as the demarcation for outcome of penetrating keratoplasty in congenital hereditary endothelial dystrophy . This was not analysed in this very important study (maybe because of small numbers) but it could have been a useful clinical hint for timing of surgery in these patients.
1. AlArrayedh H, Collum L, Murphy CC. Outcomes of penetrating keratoplasty in congenital hereditary endothelial dystrophy. Br J Ophthalmol. 2018 Jan;102(1):19-25...
1. AlArrayedh H, Collum L, Murphy CC. Outcomes of penetrating keratoplasty in congenital hereditary endothelial dystrophy. Br J Ophthalmol. 2018 Jan;102(1):19-25
2. Özdemir B, Kubaloğlu A, Koytak A, Coskun E, Çinar Y, Sari ES, Özertürk Y. Penetrating keratoplasty in congenital hereditary endothelial dystrophy. Cornea. 2012 Apr;31(4):359-65
3. Schaumberg DA, Moyes AL, Gomes JA, Dana MR. Corneal transplantation in young children with congenital hereditary endothelial dystrophy. Multicenter Pediatric Keratoplasty Study. Am J Ophthalmol. 1999 Apr;127(4):373-8