DSAEK in CHED

1. Jacqueline Beltz
2. Massimo Busin

Villa Serena Hospital, Forli', Italy

Purpose To report the results of Descemet stripping automated endothelial keratoplasty (DSAEK) performed for patients with congenital hereditary endothelial dystrophy (CHED).

Methods All charts of patients undergoing DSAEK for corneal endothelial failure in the setting of CHED at our institution between January 2007 and July 2010 were reviewed for the purposes of this study. DSAEK was performed with minor modifications to our standard technique, in particular, Descemet membrane was not stripped from the infantile patients.

Results The study consisted of 15 eyes of 8 patients with a mean age of 8.5 years (range 6months to 30 years). Detachment requiring re-bubble on day 1 or 2 occurred in 4 eyes. No further complications have been identified to date, and all corneas have clinically cleared. Visual acuity at last follow up had improved to to > 20/60 in 9 of the 9 eyes able to comply with measurements.

Conclusion. DSAEK for patients with CHED provides the chance of reduced intraoperative risk when compared to penetrating keratoplasty, and consequently surgical intervention at a younger age. Other advantages include rapid visual recovery with earlier initiation of amblyopia treatment, improved refractive outcome, and retained structural integrity of the eye. These advantages are numerous, and, whilst further studies are required, in particular in relation to visual outcome of the younger children, we believe that the decision regarding timing of surgery for patients with CHED has become easier.