Related Experiment Video
Updated: Dec 20, 2025
Murine Corneal Transplantation: A Model to Study the Most Common Form of Solid Organ Transplantation
Published on: November 17, 2014
Anatomic and visual outcomes of corneal transplantation during infancy
Raymond G Areaux1, Stephen E Orlin2, Gerald W Zaidman3
1University of Minnesota, Minneapolis.
Insights
Early penetrating keratoplasty (PKP) in infants did not significantly impact graft survival or visual outcomes compared to later PKP. However, outcomes were better than previous reports, with half of grafts lasting over five years.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Corneal Transplantation
Background:
- Congenital corneal opacities in infants often necessitate penetrating keratoplasty (PKP).
- The optimal timing for PKP in infants remains a critical question for maximizing graft survival and visual outcomes.
- Previous studies have explored late PKP, but data on early intervention is less defined.
Purpose of the Study:
- To evaluate the impact of age at penetrating keratoplasty (PKP) on graft survival and visual results in children with corneal opacities transplanted in infancy.
- To compare outcomes between early (0-90 days) and late (91-365 days) PKP in infants.
Main Methods:
- A retrospective cohort study reviewed medical records of 52 infants (62 eyes) who underwent PKP within the first year of life (2004-2011).
- PKP was categorized as early (0-90 days) or late (91-365 days).
- Graft survival and visual acuity (poor, fair, good) were the primary outcome measures, with a median follow-up of 38.1 months.
Main Results:
- Graft survival rates at 1 and 5 years were 0.92 and 0.61, respectively.
- No significant difference in graft survival was observed between early (73.7%) and late (65.1%) PKP groups (P=0.57).
- Visual outcomes also showed no significant difference between early and late PKP groups (42.1% vs 55.6% ambulatory or better vision).
Conclusions:
- Penetrating keratoplasty performed during infancy yielded better visual outcomes than previously reported for late PKP.
- Early PKP (within 3 months) did not confer improved visual outcomes compared to later infant PKP.
- While early PKP did not compromise graft survival, later infant PKP might be technically simpler.
Purpose:
To determine the effect of age at penetrating keratoplasty (PKP) on graft survival and visual outcome in children with corneal opacities transplanted during infancy.
Methods:
In this two-center retrospective consecutive cohort study, the medical records of infants who underwent unilateral or bilateral PKP during the first year of life between 2004 and 2011 were reviewed retrospectively. PKP was categorized as early (age 0-90 days) or late (age 91-365 days). Main outcome measures were graft survival and vision (classified as poor, fair, or good, considering both testing method and age norms).
Results:
A total of 62 eyes of 52 infants were included: 19 eyes underwent early PKP; 43 eyes, late PKP. Of the 62 eyes, 61 had central congenital corneal opacities; 1 was acquired. Median follow-up was 38.1 months (range, 12.2-150.5 months). Kaplan-Meier graft survival estimates were 0.92 at 1 year (95% CI, 0.81-0.96) and 0.61 at 5 years (0.44-0.74). Graft survival (early PKP, 73.7%; late PKP, 65.1% [P = 0.57]) did not differ between groups. Of the 55 eyes with recorded visual acuities, no significant difference existed in proportion with ambulatory or better vision at latest follow-up between early and late PKP (42.1% vs 55.6%; P = 0.61).
Conclusions:
Visual outcomes were better for PKP performed during infancy compared to results of prior reports of late PKP; however, clearing of congenital opacities in the first 3 months of life did not improve visual outcomes compared to later PKP. One-half of grafts survived >5 years. Early PKP did not worsen graft survival, but PKP may be technically easier to perform later in infancy.
