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. 2022 Dec 1;48(12):521-526.
doi: 10.1097/ICL.0000000000000942. Epub 2022 Sep 21.

Penetrating Keratoplasty Versus Descemet Stripping Automated Endothelial Keratoplasty in Children With Congenital Hereditary Endothelial Dystrophy: Long-Term Results

Danya Al-Dahan  1 , Ali AlRajhi, Abeer AlHazzani, Rayanah Alabdulwahid, Awad Alqarni, Muhammad A Ahad
Affiliations

Penetrating Keratoplasty Versus Descemet Stripping Automated Endothelial Keratoplasty in Children With Congenital Hereditary Endothelial Dystrophy: Long-Term Results

Danya Al-Dahan et al. Eye Contact Lens. .

Abstract

Purpose: The purpose of this study was to compare the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP) in patients with congenital hereditary endothelial dystrophy (CHED).

Methods: This was a retrospective, comparative study of all the patients with a histopathological diagnosis of CHED who underwent PKP or DSAEK between January 1, 1990, and December 31, 2016. All the cases were included except those patients who had clear grafts but did not complete 2 years of postoperative follow-up. The main outcome measure was graft clarity 2 years after surgery.

Results: There were 111 eyes of 63 patients. Seventy-six eyes underwent PKP, and 35 eyes underwent DSAEK. The median age at surgery was 6.8 years in the PKP group and 10.32 years in the DSAEK group. At 2 years postoperatively, clear grafts were noted in 66 of 76 (86.8%) eyes in the PKP group and 30 of 35 (85.7%) eyes in the DSAEK group. At the last follow-up, 80.3% of PKP grafts and 82.8% of DSAEK grafts were clear ( P =0.5). The type and timing of complications differed between the 2 groups. The PKP group had a statistically significant higher rate of graft rejection (19.5%) versus the DSAEK group (0%) ( P =0.01). DSAEK complications were mainly lenticule detachment that developed within one month postoperatively. There was no statistically significant difference in the visual outcomes at the last follow-up between the groups.

Conclusion: Endothelial keratoplasty is a safe alternative to conventional PKP in CHED. The visual outcome and survival rates were comparable, but DSAEK had a lower rejection rate and fewer suture-related complications.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

References

    1. Pearce WG, Tripathi RC, Morgan G. Congenital endothelial corneal dystrophy. Clinical, pathological, and genetic study. Br J Ophthalmol 1969;53:577–591.
    1. Al-Rajhi AA, Wagoner MD. Penetrating keratoplasty in congenital hereditary endothelial dystrophy. Ophthalmology 1997;104:956–961.
    1. Yang LH, Lambert SR, Lynn MJ, et al. Long-term results of corneal graft survival in infants and children with Peters anomaly. Ophthalmology 1999;106:833–848.
    1. Alldredge OC, Krachmer JH. Clinical types of corneal transplant rejection: Their manifestations, frequency, preoperative correlates, and treatment. Arch Ophthalmol 1981;99:599–604.
    1. Comer RM, Daya SM, O'Keefe M. Penetrating keratoplasty in infants. J AAPOS 2001;5:285–290.

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