This article is more than 5 years old. Information may no longer be current.

Two case studies suggest DSAEK can be an alternative to PK in children

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Descemet stripping automated endothelial keratoplasty may be considered a viable treatment option for managing endothelial dysfunction in children, according to results from two case studies published in the June issue of Journal of AAPOS.

Bennie H. Jeng, MD, and colleagues at Cleveland Clinic Cole Eye Institute performed DSAEK in the right eye of a 2-year-old boy with persistent corneal edema who had undergone phacoaspiration of a congenital cataract in the right eye after being diagnosed with bilateral cataract at 20 months of age.

During DSAEK, the patient received an 8-mm donor disc with an endothelial cell count of 2,829 cells/mm². Subsequently, the patient was fitted with a posterior chamber IOL in the ciliary sulcus.

In the second case study, Mark M. Fernandez, MD, and colleagues at Duke University Eye Center performed DSAEK on a 9-year-old boy with corneal decompensation and a history of persistent hyperplastic primary vitreous in the right eye. The patient had undergone phacoemulsification and implantation of a posterior chamber IOL at 7 months of age; the IOL had subsequently been removed at 3 years of age due to dislocation.

The Descemet's membrane was peeled away with an irrigation and aspiration handpiece and removed via a 4-mm corneal incision. The anterior portion of a donor corneal button was removed with an automated microkeratome, leaving an approximately 154 µm thick graft with an endothelial density of 3,344 cells/mm².

In both cases, the patients showed improved vision within a few months after DSAEK.

In addition, the authors of both studies emphasized the lower risk of certain complications after DSAEK compared with traditional penetrating keratoplasty and the easier postoperative management achieved with DSAEK because no sutures are placed in the cornea.

"Offering earlier refractive stability and better structural integrity [than traditional PK] by preserving corneal architecture, endothelial keratoplasty promises to improve the functional outcome of pediatric corneal transplantation," Dr. Fernandez and colleagues said.