Challenges in pediatric endothelial keratoplasty.
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Date
2014-02
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Abstract
We performed endothelial keratoplasty (EK) in three eyes
of two siblings (2.5 years, male and 3.5 years, female) with
congenital hereditary endothelial dystrophy (CHED) and report
the intraoperative and postoperative difficulties. Repeated
iris prolapse, apprehension of crystalline lens touch due to
positive vitreous pressure, and need for frequent air injections
to attach the graft were intraoperative challenges in all three
eyes. These were addressed by use of Sheet’s glide instead of
Busin’s glide during graft insertion and suturing of main and side ports before air injection. One eye had graft dislocation on
second postoperative day due to eye rubbing by the child. Graft
was repositioned with air and a venting incision was created.
Postoperative examination required repeated general anesthesia.
Corneal edema resolved completely in all three eyes. Present case
series highlights the possible intraoperative and postoperative
challenges and their solutions in pediatric EK for CHED.
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Keywords
Childhood corneal opacity, congenital hereditary endothelial dystrophy, corneal edema, Descemet’s stripping endothelial keratoplasty, endothelial keratoplasty, pediatric keratoplasty
Citation
Mittal Vikas, Mittal Ruchi. Challenges in pediatric endothelial keratoplasty. Indian Journal of Ophthalmology. 2014 Feb ; 62 (2): 251-254.