[Keratoplasty in children : Indications and results]

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Corneal Surgery

Background:

• Penetrating keratoplasty (PK) in children involves unique challenges compared to adults.
• Pediatric indications, examination difficulties, and parental adherence impact surgical outcomes.
• Age is a risk factor, likely due to follow-up examination and compliance issues.

Purpose of the Study:

• To outline the specific challenges and considerations for performing penetrating keratoplasty in pediatric patients.
• To identify factors influencing graft survival and visual prognosis in children undergoing PK.
• To emphasize the critical role of surgical timing in pediatric corneal transplantation.

Main Methods:

• Review of pediatric-specific indications for penetrating keratoplasty.
• Analysis of factors affecting graft survival, including age and underlying ocular conditions.
• Discussion of the risk-benefit analysis concerning graft survival and amblyopia prevention.

Main Results:

• Favorable prognoses are seen in keratoconus and herpetic keratitis.
• Sclerocornea and Peters' anomaly often have limited visual and graft survival prognosis due to ocular malformations.
• Younger age is associated with increased risk, linked to examination and compliance challenges.

Conclusions:

• Successful pediatric penetrating keratoplasty requires addressing unique challenges in indications, examination, and adherence.
• Careful patient selection and management are vital, especially for conditions like sclerocornea and Peters' anomaly.
• The timing of surgery is paramount, balancing graft success with the critical risk of amblyopia development.