Pediatric corneal transplantation: techniques, challenges, and outcomes

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Corneal Science

Background:

• Pediatric corneal transplantation presents unique surgical and clinical challenges.
• Indications include therapeutic, tectonic, optical, and cosmetic reasons.
• High-risk factors for pediatric graft failure include young age, immune response, trauma, and compliance issues.

Purpose of the Study:

• To review the epidemiology, etiology, indications, and management of pediatric corneal transplants.
• To highlight recent advances and future directions in the field.
• To emphasize factors crucial for successful pediatric corneal transplant outcomes.

Main Methods:

• Review of current literature on pediatric corneal transplantation.
• Analysis of indications, risk factors, and surgical techniques.
• Discussion of evolving management protocols and emerging technologies.

Main Results:

• Penetrating keratoplasty is common, but lamellar keratoplasty is increasingly favored for faster visual recovery and fewer complications.
• Keratoprostheses show promise for cases with multiple graft failures.
• Successful outcomes depend on meticulous pre-operative evaluation, surgical expertise, and diligent post-operative care.

Conclusions:

• Pediatric corneal transplantation requires specialized management to mitigate risks like infection, rejection, and amblyopia.
• Advancements in surgical techniques, such as lamellar keratoplasty, and devices like keratoprostheses are improving visual rehabilitation.
• Continued research and improved understanding will enhance anatomical and functional results for children requiring corneal transplants.