title: Paired-eye comparison of Descemet's stripping endothelial keratoplasty and penetrating keratoplasty in children with congenital hereditary endothelial dystrophy.
abstract: OBJECTIVE
  To report the surgical outcomes of Descemet's stripping endothelial keratoplasty (DSEK) in cases of congenital hereditary endothelial dystrophy (CHED) cohort and compare it with penetrating keratoplasty (PK) in a paired-eye setting.
  
  
  METHODS
  Ours is a retrospective, comparative, consecutive and interventional clinical case series. All patients less than 14 years of age who underwent PK in one eye and DSEK in the contralateral eye at a single centre from January 2006 and February 2011 were analysed. Main outcome measures were graft clarity, visual outcome and complications.
  
  
  RESULTS
  The mean age of the patients was 6.6±2.19 years at the time of presentation. The outcomes of two surgeries were compared with 1 year of follow-up at the corresponding follow time. At 1 year, all grafts were clear. There was no significant difference in the spherical component of the refraction; the astigmatism was significantly lower after EK. The refraction stabilised in patients with EK as early as 3 months, while it continued to change up to 1 year after PK. Complications included graft dislocation in two cases of DSEK, which were managed by rebubbling, and a graft dehiscence in one case of PK, which was managed by resuturing. The final visual acuity improved in all the patients.
  
  
  CONCLUSIONS
  Endothelial keratoplasty is a viable option to conventional PK in cases of CHED. It offers an advantage of early visual stabilisation compared with PK.
authors.affiliation: Mumbai Eye Care, Cornea and Lasik Centre, , Mumbai, India.
authors.forename: Jatin N
authors.initials: JN
authors.lastname: Ashar
authors.forename: Muralidhar
authors.initials: M
authors.lastname: Ramappa
authors.forename: Pravin K
authors.initials: PK
authors.lastname: Vaddavalli
mesh_terms: D002648:Child; D002675:Child, Preschool; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000601:surgery; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
keywords: Cornea