Corneal transplant technique shows promise i...( Philadelphia PA July 15 2008 For in...),Health

Philadelphia, PA, July 15, 2008 For infants and children with blinding diseases of the cornea, a sophisticated new corneal transplantation technique offers the hope of improving vision while overcoming the technical difficulty and low success rate of traditional penetrating keratoplasty (PK) in children, according to reports in the current issue of the Journal of AAPOS (American Association for Pediatric Ophthalmology and Strabismus).

The issue includes two case reports on the successful use of "Descemet stripping automated endothelial keratoplasty" (DSAEK) in children with corneal disease. If the promising results are borne out by further research, DSAEK could provide an alternative to traditional corneal transplantationa notoriously difficult procedure in children, failing more often than it succeeds.

Dr. Bennie H. Jeng and colleagues of The Cleveland Clinic Cole Eye Institute performed DSAEK in a 21-month-old boy, while Dr. Mark M. Fernandez and colleagues of Duke University Eye Center report the results of DSAEK in a 9-year-old boy. Both children had irreversible damage to the corneal endotheliuma specialized, single-cell layer at the rear (posterior) of the corneaafter complications of cataract surgery.

In DSAEK, the diseased endothelium is removed and replaced by a "button" of healthy endothelium from a cornea donor. After careful handling and meticulous placement, the button is held in place for the first 24 hours by nothing more than a bubble of airduring this time, the patient must lie flat to keep the air bubble and transplant in place.

In adults, DSAEK is currently "in vogue" as an alternative to traditional penetrating keratoplasty, according to a commentary by Dr. Kathryn Colby of Massachusetts Eye and Ear Infirmary, Harvard Medical School. DSAEK offers several advantages over PK. One key advantage is much more rapid recovery of visionwithin 6 to 12 weeks after DSAEK, compared to 6 to 12 months with
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