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Endothelial keratoplasty in children: surgical challenges and early outcomes
  1. Muralidhar Ramappa,
  2. Jatin Ashar,
  3. Pravin K Vaddavalli,
  4. Sunita Chaurasia,
  5. Somasheila I Murthy
  1. Cornea and Anterior Segment Services, LV Prasad Eye Institute, Hyderabad, India
  1. Correspondence to Pravin K Vaddavalli, Cornea and Anterior Segment Services, Kallam Anji Reddy Campus, LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad 500034, India; pravin{at}

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A significant proportion of paediatric keratoplasties are performed for endothelial dysfunction due to failed graft, congenital hereditary endothelial dystrophy1 and pseudophakic corneal oedema. Descemet's stripping endothelial keratoplasty (DSEK) is an evolving procedure for isolated endothelial dysfunction with encouraging results in adults. The application and outcome of this procedure in the paediatric population has not been well studied with few reports being published so far.2–5

This study reports the indications, surgical technique and early outcomes of DSEK in children <14 years of age.


All children who underwent DSEK at our centre between January 2008 and January 2010 were included. Under general anaesthesia, an appropriate sized superior or temporal fornix based conjunctival flap was reflected and a 4–5 mm long, self-sealing scleral tunnel was made. The Descemet's membrane was scored using a reverse …

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