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 transplantation—a 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 endothelium—a specialized, single-cell layer at the rear (posterior) of the cornea—after 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 air—during 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 vision—within 6 to 12 weeks after DSAEK, compared to 6 to 12 months with traditional PK surgery.
Shorter recovery time is especially important in young children with developing vision, who are at risk of further, potentially severe vision loss (amblyopia). Both children in the case reports had good results, showing improved vision within a few months after DSAEK.
Because is less invasive, DSAEK also has a lower risk of certain complications compared to PK. Postoperative management is simplified because no sutures are placed in the cornea.
Many questions remain regarding the use of DSAEK in children. Since most children who need corneal transplants have other abnormalities as well, DSAEK would be an option in only about 20 percent of cases. The need to have the patient lie flat for 24 hours after surgery poses challenges in young children, and concerns about potential complications and long-term results have to be addressed. Other treatment options are emerging as well, including the use of an artificial cornea or "keratoprosthesis."
Meanwhile, DSAEK offers an exciting new treatment possibility at least for some children with corneal disease. "We now have an expanded repertoire of better surgical options for children needing PK," Dr. Colby concludes. "The future is bright for those who undertake these challenging, but potentially life-changing, surgeries."
Jayne Dawkins | alfa
Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University
Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München
In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...
The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...
Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...
Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...
13.02.2017 | Event News
10.02.2017 | Event News
09.02.2017 | Event News
24.02.2017 | Life Sciences
24.02.2017 | Life Sciences
24.02.2017 | Trade Fair News