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Pediatric penetrating keratoplasty: indications and outcomes
1Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Tunis, Tunisia.
Insights
Pediatric penetrating keratoplasty (PKP) shows higher graft failure and worse visual outcomes than in adults. Factors like parental non-cooperation and ocular trauma significantly predict poor outcomes in pediatric PKP.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Corneal Transplantation
Background:
- Pediatric keratoplasty presents unique challenges compared to adult procedures.
- Understanding factors influencing outcomes is crucial for improving pediatric eye care.
Purpose of the Study:
- To evaluate patient characteristics, indications, and outcomes of pediatric penetrating keratoplasty (PKP).
- To identify variables predicting poor surgical outcomes in children undergoing PKP.
Main Methods:
- Retrospective review of primary PKP cases in children aged 14 years or younger.
- Data collected between January 2003 and December 2009.
Main Results:
- Sixteen PKPs were performed; indications included trauma, keratoconus, and infectious keratitis.
- Mean final visual acuity was 2/10 after 1 year, with 52% graft clarity.
- Complications included graft failure (24%) and ocular trauma (19%).
Conclusions:
- Pediatric PKP has a higher graft failure rate and worse visual prognosis than adult PKP.
- Poor outcomes are linked to parental non-cooperation and postoperative ocular trauma.
Purpose:
This report evaluates patient characteristics, indications, and outcomes of pediatric keratoplasty, and identifies variables that help to predict poor surgical outcomes.
Methods:
We undertook a retrospective review of all cases in our department of primary penetrating keratoplasty performed in children 14 years of age or younger between January 2003 and December 2009.
Results:
Sixteen primary penetrating keratoplasties were performed during the study interval. Mean age was 11.2 years (3 to 14 years) and the gender ratio was 2. The mean duration of follow-up was 16 months (2 to 36 months).The surgical indications were acquired traumatic opacities in 6 cases, keratoconus in 5 cases, corneal perforation secondary to infectious keratitis in 3 cases, hereditary corneal dystrophy in 1 case, and acquired non-traumatic opacities secondary to congenital glaucoma in one case. The initial visual acuity was less than 1/20 in 68% of cases and the mean final visual acuity after 1 year was 2/10. The graft was clear in 52% of cases after 1 year of follow-up. Postoperative complications were graft failure (24%), ocular inflammation (5%), and ocular trauma (19%).
Conclusion:
Penetrating keratoplasty in children has been documented to have a higher rate of graft failure and a worse visual prognosis than adult keratoplasty. Poor prognosis outcomes were especially caused by noncooperation of parents and postoperative ocular trauma.
