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Pediatric penetrating keratoplasty in Shanghai: a retrospective multiple centre study from 2003 to 2007
Jia-xu Hong1, Jian-jiang Xu, Min-jie Sheng
1Department of Ophthalmology, Eye & Ear, Nose, Throat Hospital of Fudan University, Shanghai, China.
Insights
Pediatric penetrating keratoplasty in Shanghai showed improved vision outcomes. Corneal graft survival is achievable in childhood, with scarring after keratitis and trauma as primary indications.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Corneal Transplantation
Background:
- Pediatric keratoplasty success rates have risen.
- Limited epidemiological data exists for pediatric corneal transplantation in China.
- This study examines indications and characteristics of pediatric penetrating keratoplasty in Shanghai.
Purpose of the Study:
- To investigate the indications for pediatric penetrating keratoplasty.
- To analyze the characteristics of pediatric corneal transplantation in Shanghai.
- To evaluate visual outcomes and graft survival rates in children.
Main Methods:
- Retrospective study of 156 eyes in 149 children (<14 years) from 2003-2007.
- Data collected from four ophthalmic units in Shanghai.
- Analysis of indications, demographics, and visual acuity outcomes.
Main Results:
- Most common indications: scarring after keratitis (29.5%) and traumatic corneal scar (19.2%).
- Median age at surgery was 9 years.
- Visual acuity significantly improved 1 year postoperatively (P=0.001), with 13% achieving BCSVA of 6/18 or better.
Conclusions:
- Pediatric penetrating keratoplasty in Shanghai provides valuable epidemiological data.
- No significant difference in graft survival rates between the two main indications.
- Corneal transplantation significantly improves vision in Chinese children, demonstrating successful graft survival in childhood.
Background:
With advances in pediatric keratoplasty over the last two decades, the success rate of surgery has increased remarkably. However, few epidemiological studies in this field have been performed in China. The present study investigated the indications and characteristics of pediatric penetrating keratoplasty in Shanghai.
Methods:
All records of pediatric keratoplasty performed on 156 eyes in 149 children (< 14 years) at four ophthalmic units in Shanghai during a 5-year period (2003 - 2007) were used for this retrospective study. Patients were from the Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai No.10 People's Hospital, Shanghai No.1 People's Hospital, and Shanghai Peace Ophthalmology Hospital; and included mostly school-age children (97 boys and 59 girls).
Results:
The median age at surgery was 9 years with an interval quartile range of 6-12 years. Scarring after keratitis (29.5%, 46/156) and traumatic corneal scar (19.2%, 30/156) were the most common indications. Best Corrected Snellen visual acuity (BCSVA) was reported only in 72% (112/156) of cases. Visual acuity outcomes were significantly better for keratoplasty 1 year postoperatively compared to preoperative visual acuity (P = 0.001). Of all patients, 13% (14/112) achieved a BCSVA of 6/18 or better. None of the indications was associated with a higher rate of failure compared to after 1 year follow-up.
Conclusion:
We obtained valuable information on pediatric keratoplasty in Shanghai. There was no significant difference in graft survival rate among the two indications. Vision outcomes after corneal transplantation in Chinese children were significantly better compared with pre-operation status. In conclusion, corneal graft survival can be achieved in childhood.
