[Postoperative complications of penetrating subtotal keratoplasty in children]

Accordingly to experience of corneal transplantations during 1981-2001 in the children's clinic of the Helmholz Moscow Research Institute of Ocular Diseases the authors present the clinical picture, rate, prognostic value and modes of correction of postoperative complications after keratoplasty. A retrospective study analyzed the incidence of complications after 94 penetrating keratoplasties performed in 82 children aged from 10 months to 14 years in 89 eyes for congenital corneal opacity (n = 22) or corneal opacity caused by trauma (n = 40) or inflammation (n = 20). 60 (73%) within 1 year after operation developed different reactions and complications due to transplant failure in 41 (44%) cases. Among them there were graft rejection episodes (34%), anterior synechiae and retrocorneal membrane formation (17%), donor corneal neovascularization (11%), elevated intraocular pressure (11%). There were a few cases with shallow anterior chamber, hyphema/hemophthalmos, retinal detachment, primary graft failure, corneal ulcer, suture infiltrates and abscesses. Subatrophy of the eye was an outcome in 3 cases. The development of complications after penetrating keratoplasty is determined mainly by the physiology of children, age, severity of underlying and concomitant pathology of the eye. Nevertheless, the odds of donor tissue for transparent graft survival increase if such complications are detected and removed.