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Published on: September 17, 2014
Penetrating keratoplasty in children: visual and graft outcome
1Department of Clinical Ophthalmology and Save Sight Institute, University of Sydney, GPO Box 4337, Sydney NSW 2001, Australia. kathy@eye.usyd.edu.au
Insights
Penetrating keratoplasty in children can achieve long-term graft survival. However, optimal visual acuity restoration after corneal transplantation requires normal visual development prior to corneal opacification.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Corneal Surgery
Background:
- Penetrating keratoplasty (PKP) is a surgical procedure to restore vision in cases of corneal opacity.
- Pediatric PKP presents unique challenges and outcomes compared to adult procedures.
- Understanding factors influencing graft survival and visual acuity is crucial for pediatric eye care.
Purpose of the Study:
- To review factors affecting graft survival after PKP in children.
- To identify determinants of visual acuity outcomes post-PKP in pediatric patients.
Main Methods:
- Retrospective review of all pediatric PKP cases (age < 15 years) performed between 1984 and 2002.
- Analysis of graft survival rates and postoperative visual acuity.
- Correlation of outcomes with indications for transplantation and visual development.
Main Results:
- 19 PKPs were performed in 18 eyes of 16 children with a mean follow-up of 6.6 years.
- Corneal graft survival was 73.7% up to 14 years.
- Visual acuity outcomes varied by indication: congenital cases had poorer outcomes (14.2% > 6/60) compared to keratoconus (all ≥ 6/12).
Conclusions:
- Prolonged corneal graft survival is achievable in pediatric patients.
- Successful visual acuity restoration is contingent on pre-existing normal visual development before corneal opacification.
Aims:
To review factors affecting graft survival and determinants of visual acuity after penetrating keratoplasty in children.
Methods:
All cases of penetrating keratoplasty performed in an ophthalmic unit, in children aged less than 15 years at the time of operation, for the period 1984 to 2002 were included.
Results:
19 penetrating keratoplasties were done in 18 eyes of 16 children, age range 2 weeks to 14 years 8 months (mean 9.24 years), with mean follow up 6.6 years. 73.7% of grafts have remained clear for up to 14 years. Postoperative visual acuity among congenital indications for graft was better than 6/60 in only 14.2% of cases, but was better than or equal to 6/12 in all cases of keratoconus.
Conclusion:
This series shows that prolonged corneal graft survival can be achieved in children, but successful restoration of visual acuity depends upon a period of normal visual development before the onset of corneal opacification.
