Abstract
Purpose
To evaluate the outcomes of Descemet's stripping endothelial keratoplasty (DSEK) in patients with congenital hereditary endothelial dystrophy (CHED).
Methods
Retrospective, interventional case series of five eyes of five patients with congenital hereditary endothelial dystrophy (CHED) undergoing Descemet's stripping endothelial keratoplasty (DSEK) from June 2009 to June 2010 by a single surgeon. Patients were evaluated during the postoperative period for visual acuity, refraction, corneal clarity, lenticule status, and intraocular pressure. Anterior segment ocular coherence tomography (OCT) and confocal microscopy were performed when possible.
Results
Three male and two female children with an average age of 7.8 years (range 5–12 years) with CHED underwent DSEK. Surgery was uneventful in all patients and the lenticules stayed attached during the postoperative period. All the patients had 1-year follow-up. Corneal clarity improved in all the patients over the period of follow-up. Anterior segment OCT showed a gradual reduction in the thickness of the central corneal thickness and the graft over a period of time.
Conclusions
DSEK is a viable alternative to penetrating keratoplasty in patients with CHED with distinct advantages of reduced postoperative astigmatism and potential reduction of postoperative complications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Lee WB, Jacobs DS, Musch DC, Kaufman SC, Reinhart WJ, Shtein RM (2009) Descemet’s stripping endothelial keratoplasty: safety and outcomes: a report by the American Academy of Ophthalmology. Ophthalmology 116:1818–1830
Kirkness CM, McCartney A, Rice NS, Garner A, Steele AD (1987) Congenital hereditary corneal edema of Maumenee: its clinical features, management, and pathology. Br J Ophthalmol 71:130–144
Kenyon KR, Antine B (1971) The pathogenesis of congenital hereditary endothelial dystrophy of the cornea. Am J Ophthalmol 72:787–795
Pearce WG, Tripathi RC, Morgan GO (1969) Congenital endothelial corneal dystrophy: clinical, pathological and genetic study. Br J Ophthalmol 53:577–591
Judisch GF, Maumenee IH (1978) Clinical differentiation of recessive congenital hereditary endothelial dystrophy and dominant hereditary endothelial dystrophy. Am J Ophthalmol 85:606–612
Vanathi M, Panda A, Vengayil S, Chaudhuri Z, Dada T (2009) Pediatric keratoplasty. Surv Ophthalmol 54:245–271
Sajjadi H, Javadi MA, Hemmati R, Mirdeghan A, Parvin M, Nassiri N (1995) Results of penetrating keratoplasty in CHED. Cornea 14:18–25
Al-Rajhi AA, Wagoner MD (1997) Penetrating keratoplasty in congenital hereditary endothelial dystrophy. Ophthalmology 104:956–961
Schaumberg DA, Moyes AL, Gomes JA, Dana MR (1999) Corneal transplantation in young children with congenital hereditary endothelial dystrophy. Multicenter pediatric keratoplasty study. Am J Ophthalmol 127:373–378
Javadi MA, Baradaran-Rafii AR, Zamani M, Karimian F, Zare M, Einollahi B, Jafarinasab MR, Yazdani S (2003) Penetrating keratoplasty in young children with congenital hereditary endothelial dystrophy. Cornea 22:420–423
Jeng BH, Marcotty A, Traboulsi EI (2008) Descemet stripping automated endothelial keratoplasty in a 2-year-old child. J AAPOS 12:317–318
Fernandez MM, Buckley EG, Afshari NA (2008) Descemet stripping automated endothelial keratoplasty in a child. J AAPOS 12:314–316
Ponchel C, Malecaze F, Arné JL, Fournié P (2009) Descemet stripping automated endothelial keratoplasty in a child with Descemet membrane breaks after forceps delivery. Cornea 28:338–341
Pineda R, Jain V, Shome D, Hunter DC, Natarajan S (2010) Descemet's stripping endothelial keratoplasty: is it an option for congenital hereditary endothelial dystrophy? Int Ophthalmol 30:307–310
Inoue T, Oshima Y, Hori Y, Maeda N (2010) A chandelier-illuminated anterior chamber maintainer for use during Descemet stripping automated endothelial keratoplasty in patients with advanced bullous keratopathy. Cornea 29:917–920
Inoue T, Oshima Y, Shima C, Hori Y, Maeda N, Tano Y (2008) Chandelier illumination to complete Descemet stripping through severe hazy cornea during Descemet stripping automated endothelial keratoplasty. J Cataract Refract Surg 34:892–896
Busin M, Beltz J, Scorcia V (2011) Descemet-stripping automated endothelial keratoplasty for congenital hereditary endothelial dystrophy. Arch Ophthalmol 129:1140–1146
Kobayashi A, Yokogawa H, Sugiyama K (2007) Non-Descemet stripping endothelial keratoplasty for endothelial dysfunction secondary to argon laser iridotomy. Am J Ophthalmol 146:534–549
Kobayashi A, Yokogawa H, Sugiyama K (2009) In vivo laser confocal microscopy after non-Descemet’s stripping automated endothelial keratoplasty. Ophthalmology 116:1306–1313
Acknowledgments
a. Funding/Support (including none) : Hyderabad Eye Research Foundation
b. Financial Disclosures (including none): None of the authors has any financial disclosures or conflicts of interest with the material in this manuscript.
c. Contributions of the authors in each of these areas :
Design and conduct of the study: PKV
Data collection, management, analysis, and interpretation: JA, MLK, PKV
Preparation, review or approval of the manuscript: JA, MLK, PKV
d. Statement about conformity with author information :
Study approved by IRB of Hyderabad Eye Institute
Informed consent for all the procedures was obtained from all the patients.
e. Other Acknowledgments :None.
Competing Interest
None to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ashar, J.N., Madhavi Latha, K. & Vaddavalli, P.K. Descemet's stripping endothelial keratoplasty (DSEK) for children with congenital hereditary endothelial dystrophy: surgical challenges and 1-year outcomes. Graefes Arch Clin Exp Ophthalmol 250, 1341–1345 (2012). https://doi.org/10.1007/s00417-012-2014-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-012-2014-8