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BRIEF COMMUNICATION
Year : 2014  |  Volume : 62  |  Issue : 2  |  Page : 251-254

Challenges in pediatric endothelial keratoplasty


1 Cornea and Anterior Segment Services, Sanjivni Eye Care, Model Town, Ambala, Haryana, India
2 Vitreoretina Services, Sanjivni Eye Care, Model Town, Ambala, Haryana, India

Correspondence Address:
Vikas Mittal
Consultant Cornea and Refractive Surgeon, Sanjivni Eye Care, Model Town, Ambala City - 134 002, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.128638

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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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