This document discusses various topics related to corneal transplantation including congenital and acquired corneal diseases, preoperative, intraoperative and postoperative considerations for corneal transplantation, and complications after surgery. It also addresses special considerations for pediatric keratoplasty and techniques such as DALK, DSAEK and femtosecond keratoplasty. Establishing the correct diagnosis, assessing visual potential and comorbidities, and the ability of families to provide postoperative care are identified as important factors in the management of corneal diseases in children.

1. Dr M.Vanathi MD
Additional Prof of Ophthalmology
Cornea & Ocular Surface, Cataract & Refractive Surgery
Dr R P Centre, AIIMS, New Delhi
Financial Interests: NIL

2. 2
Dr R P Centre, AIIMS, New Delhi
Congenital CO :
CHED

3. 3
Dr R P Centre, AIIMS, New Delhi
Congenital CO :
CHED
Congenital CO:
non-CHED

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Dr R P Centre, AIIMS, New Delhi
Congenital CO :
CHED
Congenital CO:
non-CHED

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Dr R P Centre, AIIMS, New Delhi
Congenital CO :
CHED
Congenital CO:
non-CHED
AcquiredTraumatic
Acquired Non-
traumatic

6. 6
Dr R P Centre, AIIMS, New Delhi
Congenital CO :
CHED
Congenital CO:
non-CHED
AcquiredTraumatic
Acquired Non-
traumatic

7. 7Dr R P Centre,AIIMS, New Delhi
Preoperative
Intra-
operative
Post -
operative

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Scleral fixation rings
Scleral fixation
rings
Corneal centration
marking
Scleral
fixation
rings
Corneal
centration
marking
Appropriate
Trephine
size
Scleral
fixation
rings
Corneal
centration
marking
Appropriate
Trephine size
Corneoiridic
adhesions
Scleral fixation rings
Corneal centration
marking
Appropriate Trephine
size
Corneoiridic
adhesions
Peripheral
Iridectomy
Scleral fixation rings
Corneal centration
marking
Appropriate Trephine
size
Corneoiridic
adhesions
Peripheral
Iridectomy
Suturing
Considerations
Dr R P Centre, AIIMS, New Delhi

9. Dr R P Centre,AIIMS, New Delhi 9

10. Dr R P Centre,AIIMS, New Delhi 10

11. Dr R P Centre,AIIMS, New Delhi 11

12. Dr R P Centre,AIIMS, New Delhi 12

13. Dr R P Centre,AIIMS, New Delhi 13

14. Dr R P Centre,AIIMS, New Delhi 14

15. Dr R P Centre,AIIMS, New Delhi 15

16. Dr R P Centre,AIIMS, New Delhi 16

17. Dr R P Centre,AIIMS, New Delhi 17

18. Small size of globe
Reduced rigidity of
cornea & sclera
Positive vitreous
pressure with
frequent forward
placement of Iris-
lens diaphragm
Optimal
preoperative
planning
18
Technically
more
demanding
Dr R P Centre, AIIMS, New Delhi

19. Increased
inflammation
EUA
Secondary
glaucoma
Immune rejections
19
Postoperative
Dr R P Centre, AIIMS, New Delhi
Rapid Suture
loosening
Frequent
postoperative
EUAs for suture
replacements
Compliance to
medications
Postoperative
Visual
rehabilitation

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Dr R P Centre, AIIMS, New Delhi

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Dr R P Centre, AIIMS, New Delhi

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Dr R P Centre, AIIMS, New Delhi

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Dr R P Centre, AIIMS, New Delhi

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Dr R P Centre, AIIMS, New Delhi
Graft Infection

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Dr R P Centre, AIIMS, New Delhi
Graft Infection Glaucoma

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Dr R P Centre, AIIMS, New Delhi
Graft Infection Glaucoma
Astigmatism

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Dr R P Centre, AIIMS, New Delhi
Graft Infection Glaucoma
Astigmatism Graft Rejection

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Dr R P Centre, AIIMS, New Delhi
Triple Procedure in AcquiredTraumatic
corneo-iridic scar
Keratoplasty in Buphthalmos

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Dr R P Centre, AIIMS, New Delhi
Pediatric PK + GDD
Femtosecond
Keratoplasty
DALK DSAEK

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Dr R P Centre, AIIMS, New Delhi

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Dr R P Centre, AIIMS, New Delhi
Establishing a
diagnosis

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Dr R P Centre, AIIMS, New Delhi
Establishing a
diagnosis
Determining visual
potential & risk of
amblyopia

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Dr R P Centre, AIIMS, New Delhi
Establishing a
diagnosis
Determining visual
potential & risk of
amblyopia
Assessing for the
presence of ocular
comorbidities that will
need to be
concurrently
managed, such as
glaucoma, or that may
limit visual potential

34. 34
Dr R P Centre, AIIMS, New Delhi
Establishing a
diagnosis
Determining visual
potential & risk of
amblyopia
Assessing for the
presence of ocular
comorbidities that will
need to be
concurrently
managed, such as
glaucoma, or that may
limit visual potential
Judging the ability of
the family to
participate in and
followup & the
rigorous
postoperative care &
visual rehabilitation

35. 35
Dr M.Vanathi
R P C – AIIMS
vanathi_g@yahoo.com
ACKNOWLEDGMENTS:
NATIONAL EYE BANK – AIIMS
Prof J S Titiyal
Prof Radhika Tandon
Prof N Sharma
CORNEA TEAM – R P Centre