Outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) performed in children younger than 16 years

Session Details

Session Title: Cornea: Surgical I

Session Date/Time: Tuesday 08/09/2015 | 08:00-10:30

Paper Time: 10:06

Venue: Room 10

First Author: : L.Mattioli ITALY

Co Author(s): :    C. Bovone   L. Pia Ester   M. Busin              

Abstract Details

Purpose:

To report the outcomes of DSAEK surgery performed in pediatric patients.

Setting:

Interventional case series of eyes operated by a single surgeon (MB). Institution Villa Igea, Forli, or at a public hospital,Ospedale M.Bufalini, Cesena, Italy

Methods:

The records of all patients up to the age of 16 years undergoing DSAEK at our Institution (Villa Igea, Forli') or at a public hospital (Ospedale M.Bufalini, Cesena) since January 2014 were reviewed. Slit-lamp examination, refraction and visual acuity as well as endothelial cell density were evaluated preoperatively as well as 1, 3, 6, 12, and 18 months postoperatively.

Results:

DSAEK was performed in 128 eyes of 17 patients (congenital hereditary endothelial dystrophy n = 20; congenital glaucoma n = 4; posterior polymorphous dystrophy n = 2, and failed penetrating keratoplasty n = 3). All surgeries were uneventful. Graft detachment occurred in 5 cases and was managed successfully with air injection. All corneas cleared within a week from surgery. At last visit, best-corrected visual acuity was better than 20/40 in 11 of the 15 cases of patients old enough to assess vision. In one eye a graft rejection episode was noted and successfully treated with steroids. No grafts have failed.

Conclusions:

DSAEK is suitable for children with corneal endothelial failure. In contrast to penetrating keratoplasty, this surgery is performed under “closed eye” conditions, thus minimizing intraoperative risks. After DSAEK, all sutures can be removed within 2-4 weeksfrom surgery (depending on age), thus allowing an early start of amblyopia treatment and visual recovery.

Financial Interest:

One of the authors travel has been funded, fully or partially, by a competing company