Related Experiment Videos
Successful visual rehabilitation after neonatal penetrating keratoplasty
1Children's Hospital of Philadelphia, PA 10104, USA.
Insights
Neonatal penetrating keratoplasty can restore vision in infants with congenital corneal opacification. Early surgery, combined with optical correction and amblyopia therapy, yields successful long-term visual outcomes.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Corneal Transplantation
Background:
- Infantile penetrating keratoplasty (PKP) historically faced challenges due to unique pediatric physiology and surgical difficulties.
- Advances in microsurgery and understanding of visual development have expanded indications for PKP in children.
- This study reports long-term outcomes of neonatal PKP for unilateral congenital corneal opacification.
Observation:
- Two infants underwent PKP within the first three weeks of life for congenital corneal opacification.
- Post-operative management included amblyopia treatment and optical correction.
- Follow-up extended to six years post-surgery.
Findings:
- Both corneal grafts remained clear at the six-year mark.
- One patient developed infantile esotropia.
- Age-appropriate visual development was achieved in both transplanted eyes using Snellen optotypes.
Implications:
- Neonatal PKP, when combined with optical correction and amblyopia therapy, can be a viable option for vision restoration.
- Early surgical intervention in congenital corneal opacification can lead to preserved vision.
- This approach offers hope for selected infants with severe corneal disease.
Background:
Penetrating keratoplasty in infancy and childhood has traditionally met with limited visual success due to a combination of unique physiology and technical problems in this patient population. With the advances in microsurgical instrumentation, corneal preservation, and visual developmental physiology ophthalmologists are finding increasing indications for penetrating keratoplasty in the childhood population. The long term results of neonatal penetrating keratoplasty in two patients with unilateral congenital corneal opacification are reported.
Methods:
Penetrating keratoplasty was performed on one eye in each of two infants within the first 3 weeks of life. Amblyopia treatment and optical therapy have been continued since surgery.
Results:
After 6 years both grafts have remained clear. One patient developed the infantile esotropia syndrome. Visual development using Snellen optotypes is age normal for both transplanted eyes.
Conclusions:
Penetrating keratoplasty when combined with optical correction and amblyopia therapy may restore and preserve vision in selected patients with congenital corneal opacification if performed in the neonatal period.