Dr. MURALEEDHARA R.

Abstract

Descemet’s stripping automated endothelial keratoplasty (DSEK) has been the current standard of care for tackling endothelial dysfunction. However, its usefulness in the pediatric population is still debated, with insufficient literature supporting its merits. Herein we present the largest retrospective study describing the successful outcome of DSAEK in children with CHED with unusual striae at Bowman’s level.

While DSAEK seems to offer better graft outcomes and visual prognosis in children with CHED, 2/3rd of these eyes had a BMS. The late surgical intervention appears to be an independent risk factor. Bowman’s membrane wrinkles, perhaps due to rapid corneal thinning after DSEAK. This video focuses on applying newer investigational modalities to unravel Bowman’s membrane striae (BMS) after a DSAEK in cases of congenital hereditary endothelial dystrophy (CHED).We describe a systematic approach to unraveling BMS and its clinical implications