Corneal transplantation in children

Area of Science:

• Ophthalmology
• Transplantation Surgery
• Pediatric Medicine

Background:

• Corneal transplantation, or penetrating keratoplasty, is a critical procedure for restoring vision in cases of severe corneal pathology.
• Pediatric corneal transplantation presents unique challenges and requires careful evaluation of outcomes.

Purpose of the Study:

• To evaluate the surgical success and visual results of penetrating keratoplasty in pediatric patients.
• To analyze graft survival rates and factors influencing visual acuity post-transplantation in children.

Main Methods:

• Retrospective analysis of 25 corneal transplants performed in 24 pediatric eyes (ages 6-16) between 1994-1999.
• Inclusion of diverse corneal pathologies: corneal leucoma, congenital dystrophy, corneal combustion, post-injury scars, keratoconus, melting, hematocornea, and re-keratoplasty.
• Minimum follow-up period of 6 months to assess graft survival and visual outcomes.

Main Results:

• One-year graft survival rates reached 75% for eyes with congenital dystrophy and keratoconus.
• Procedures for hematocornea and re-keratoplasty resulted in graft failure.
• Postoperative visual acuity improvement was observed in 14 out of 25 transplanted eyes.

Conclusions:

• Penetrating keratoplasty in children offers very good surgical success for various corneal conditions.
• While surgical success is high, final visual outcomes are significantly impacted by the presence of irreversible amblyopia.
• Careful patient selection and management of pre-existing conditions like amblyopia are crucial for optimizing visual results in pediatric corneal transplantation.