Outcomes of penetrating keratoplasty in congenital hereditary endothelial dystrophy

AlArrayedh, Hamed; Collum, L. M. T.; Murphy, Conor C

doi:10.1136/bjophthalmol-2016-309565

Cited by 21 publications

(13 citation statements)

References 23 publications

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“…Other complications were uncommon, with only one case developing endothelial rejection. These outcomes are in contrast to the poor ones reported previously on PK for CHED (Schaumberg et al 1999;€ Ozdemir et al 2012;AlArrayedh et al 2018), whilst are in line with others reported on DSAEK for paediatric eyes (Madi et al 2012;Ramappa et al 2012;Ashar et al 2013aAshar et al , 2013bScorcia et al 2016;Yang et al 2020). Although DMEK is technically feasible in paediatric patients (Mittal et al 2021), it remains our preference to perform DSAEK considering the higher risk of graft detachment in DMEK, which would often require re-bubbling procedures under general anaesthesia.…”

Section: Discussionsupporting

confidence: 89%

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10‐year experience with lamellar keratoplasty for the surgical Management of Paediatric Corneal Diseases

Pellegrini

Salgari

D’Angelo

et al. 2022

Acta Ophthalmologica

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Purpose To evaluate the outcomes of various lamellar keratoplasty techniques performed at our Institution in children aged 14 years or younger over the last decade. Methods This single‐centre study reviewed 72 eyes that underwent lamellar keratoplasty for various indications. Deep anterior lamellar keratoplasty (DALK) was performed in 19 eyes, mushroom penetrating keratoplasty (PK) in 27 eyes and Descemet stripping automated endothelial keratoplasty (DSAEK) in 25 eyes. The main outcome measures included best spectacle‐corrected visual acuity (BSCVA), complications and rate of graft failure which was defined as any graft requiring repeat transplantation. Results Best spectacle‐corrected visual acuity (BSCVA) significantly improved after DALK, mushroom PK and DSAEK (all p < 0.05), with 50%, 60% and 56% of eyes reaching ≥20/40, respectively. Stromal rejection was observed in 1 eye (5.3%) after DALK, whilst endothelial rejection occurred in 1 eye after mushroom PK (3.7%) and 1 eye after DSAEK (4.0%). Overall survival was 100% after DALK (mean follow‐up: 23.0 months), 92.8% after mushroom PK (mean follow‐up: 42.3 months) and 96.0% after DSAEK (mean follow‐up: 33.6 months). Conclusion Deep anterior lamellar keratoplasty (DALK), mushroom PK and DSAEK offer good visual outcomes for children with corneal pathology, with low rates of immunological rejection and graft failure.

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Section: Discussionsupporting

confidence: 89%

“…2012; AlArrayedh et al. 2018), whilst are in line with others reported on DSAEK for paediatric eyes (Madi et al. 2012; Ramappa et al.…”

Section: Discussionsupporting

confidence: 85%

10‐year experience with lamellar keratoplasty for the surgical Management of Paediatric Corneal Diseases

Pellegrini

Salgari

D’Angelo

et al. 2022

Acta Ophthalmologica

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“…Reforzando la idea de que la especificidad de la indicación es importante para el resultado del trasplante. [20] Se ha observado que los mejores resultados se presentan en pacientes con fines ópticos, como es el caso de las cicatrices u opacidades. El Herpes causa una infección corneal que deja como resultado una opacidad.…”

Section: Estado Del Arteunclassified

Corneal Transplantation in New Zealand 2000 to 2009

Crawford

Krishnan

Ormonde

et al. 2017

Cornea

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“…[10][11][12] However, the trend is shifting towards endothelial keratoplasties over PKP due to various reasons such as suturerelated complications, increased risk of graft rejection and failure, unstable refractive outcomes and need for multiple examinations under anaesthesia in post PKP children. [13][14][15] A study by AlArrayedh et al 16 demonstrated poor outcomes from PKP in CHED due to dense amblyopia and high risk of long-term graft failure. The outcomes of PKP were better when the surgery was done at an older age when compared to the early intervention.…”

Section: Discussionmentioning

confidence: 99%

Microscope Integrated Optical Coherence Tomography Guided Descemet Stripping Automated Endothelial Keratoplasty in Congenital Hereditary Endothelial Dystrophy

Asif

Bafna

Sharma

et al. 2021

OPTH

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Purpose: To describe the outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) in congenital hereditary endothelial dystrophy (CHED) and to evaluate the role of microscope integrated optical coherence tomography (Mi-OCT) during the surgery. Design: Retrospective data analysis. Methods: A retrospective study from the medical records of all those patients who were diagnosed with CHED and underwent DSAEK at our centre from 2015 were evaluated. All patients underwent Mi-OCT-guided standard DSAEK procedure. Intra-operative difficulties, visual outcomes and graft survival were recorded. Results: A total of 48 eyes of 29 patients with a mean age of 9.87 ± 8.2 years and mean follow-up of 17.3 months were evaluated. Thirty-nine eyes underwent primary DSAEK and 9 eyes underwent PKP. Three eyes who underwent PKP had failed graft for which they underwent DSAEK. The mean preoperative Snellen's visual acuity was 1.71 ± 0.66 and the mean preoperative central corneal thickness was 1.10 ± 0.174 mm. Intraoperatively, all the grafts were attached which was confirmed using Mi-OCT. Graft detachment was seen in the immediate postoperative period in 10.4% (4 eyes) of primary DSAEK, out of which DM scoring was not performed in 2 eyes. Following DSAEK, cornea cleared at four-week follow-up in 89.7% eyes and in all the eyes the cornea cleared at six-week follow-up. Conclusion: Primary DSAEK could be a preferred option over PKP for CHED with early presentation and in those eyes with failed primary PKP. Mi-OCT is a very useful tool in these eyes for various intraoperative procedures, thereby improving the outcomes of the procedure.

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Outcomes of penetrating keratoplasty in congenital hereditary endothelial dystrophy

Abstract: This study has demonstrated a poor outcome from PKP for CHED in this Irish cohort. This arises from a combination of dense amblyopia and a high risk of graft failure in the long term.

Cited by 21 publications

References 23 publications

10‐year experience with lamellar keratoplasty for the surgical Management of Paediatric Corneal Diseases

10‐year experience with lamellar keratoplasty for the surgical Management of Paediatric Corneal Diseases

Corneal Transplantation in New Zealand 2000 to 2009

Microscope Integrated Optical Coherence Tomography Guided Descemet Stripping Automated Endothelial Keratoplasty in Congenital Hereditary Endothelial Dystrophy

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