Which statement describes EK relative to Downs syndrome?

• A. Downs syndrome can be used for EK only
• B. Downs syndrome is contraindication for EK
• C. Downs syndrome has no effect on EK
• D. Downs syndrome prohibits PKP only

Answer: (A)

This item is about choosing the corneal transplant approach that best fits a patient with Down syndrome. Endothelial keratoplasty (EK) is a targeted procedure that replaces only the dysfunctional endothelial layer of the cornea, leaving the rest of the cornea intact and usually requiring less suturing, shorter surgery time, and quicker recovery than a full-thickness transplant.

Why this option fits best: Down syndrome can present challenges with cooperation and postoperative care. EK offers a less invasive way to restore corneal clarity by addressing just the endothelial failure, which aligns well with those needs. It avoids the greater complexity and longer recovery associated with penetrating keratoplasty (PKP), making EK a practical choice for these patients. The other statements don’t align with how the procedure is selected in this context: DS is not a contraindication for EK, it does have an impact on the choice by favoring a less invasive approach, and DS does not necessarily prohibit PKP—but EK is typically preferred for these cases.