Endothelial keratoplasty for posterior polymorphous corneal dystrophy in a 4-month-old infant

PURPOSE: To report a case of endothelial keratoplasties (EKs) performed in a 4 month old with a posterior polymorphous corneal dystrophy. OBSERVATIONS: A 4 month old infant underwent Descemet membrane endothelial keratoplasty (DMEK) for posterior polymorphous corneal dystrophy. The graft was found to be dislocated on day 5 post-operatively and an attempt to unfold the DMEK scroll and re-bubble was not successful. The patient was then treated successfully with bilateral Descemet stripping automated endothelial keratoplasty (DSAEK). At 3 years of follow-up, her visual acuity was 20/70 in the right and 20/60 in the left eye with good endothelial cell counts. CONCLUSIONS AND IMPORTANCE: and Importance: This study reports the youngest case of EKs performed at the age of 4 months in an infant. This is also the first reported case of attempted DMEK highlighting its challenges in infants. DSAEK remains a good treatment option for endothelial dysfunction secondary to posterior polymorphous corneal dystrophy in infants even after failed DMEK.