Endothelial keratoplasty in children: surgical challenges and early outcomes
- Cornea and Anterior Segment Services, LV Prasad Eye Institute, Hyderabad, India
- 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}lvpei.org
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Contributors Conception and design, or analysis and interpretation of data: JA, PV, MR; drafting the article or revising it critically for important intellectual content: JA, PV, MR, SC, SM; and final approval of the version to be published: PV. MR and JA contributed equally.
- Paediatric keratoplasty
- endothelial keratoplasty
- Descemet's stripping endothelial keratoplasty
- cornea
- dystrophy
- eye (tissue) banking
- ocular surface
- optics and refraction
- infection
- immunology
- imaging
- microbiology
- inflammation
Introduction
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.
Methods
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 …
