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Corneal Donor Tissue Preparation for Endothelial Keratoplasty
Published on: June 12, 2012
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Challenges in pediatric endothelial keratoplasty.
1Cornea and Anterior Segment Services, Sanjivni Eye Care, Model Town, Ambala, Haryana, India.
Indian Journal of Ophthalmology
|March 13, 2014
Summary
Pediatric endothelial keratoplasty (EK) for congenital hereditary endothelial dystrophy (CHED) presents unique surgical challenges. This case series details successful management strategies for intraoperative and postoperative complications in young siblings undergoing EK.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Corneal Surgery
Background:
- Congenital hereditary endothelial dystrophy (CHED) is a rare condition affecting corneal clarity.
- Endothelial keratoplasty (EK) is a surgical option for endothelial dysfunction.
- Pediatric EK presents distinct challenges compared to adult procedures.
Observation:
- Three eyes of two young siblings (2.5 and 3.5 years old) with CHED underwent EK.
- Intraoperative difficulties included iris prolapse, risk of lens touch, and graft adherence issues.
- Postoperative graft dislocation occurred in one eye due to eye rubbing.
Findings:
- Specific surgical techniques, including Sheet's glide and port suturing, mitigated intraoperative challenges.
- Repositioning the graft with air and creating a venting incision addressed postoperative dislocation.
- Complete corneal edema resolution was achieved in all three eyes.
Implications:
- This case series provides valuable insights into managing complex pediatric EK cases for CHED.
- Modified surgical approaches can overcome common intraoperative and postoperative hurdles.
- Successful EK in CHED patients can restore corneal clarity and improve vision in children.
