[Penetrating keratoplasty in primary congenital glaucoma]

We present preliminary research on penetrating keratoplasty in corneal dystrophy secondary to congenital glaucoma. The aim was to analyse the functional and anatomic results of this morbid condition where visual prognosis is usually poor.

Six cases of congenital glaucoma in which the ocular pressure is controlled were studied. Age varied from 10 months to 11 years, the medium age was 47.7 months (SD: 42.8). These patients underwent penetrating keratoplasty. Recession varied from 3 months to 29 months, with a medium recession of 18.4 months (SD: 11.54).

Anatomic results: the graft remained transparent in 5 eyes. Some postoperative complications were noticed: ocular hypertonia medically treated in one case, minor uveitis in one case, total cataract operated by phacophagy with a final outcome of ophthalmomalacia, buphtalmia (31.5 of diameter and ocular tonus at 7 mmHg). Functional results: an amelioration of visual acuity was obtained in 5 of 6 cases.

The anatomic and functional results were satisfactory. Ocular pressure must be normalised before keratoplasty. Important buphtalmia constitutes one contra-indication to this intervention. Hypotonia would appear to be a factor of poor prognosis.