Research Article

Indications, Surgical Techniques and Visual Outcomes of Pediatric Keratoplasty

Volume: 16 Number: 1 January 1, 2025
Acıbadem Üniversitesi Sağlık Bilimleri Dergisi Cover
Acıbadem Üniversitesi Sağlık Bilimleri Dergisi
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Indications, Surgical Techniques and Visual Outcomes of Pediatric Keratoplasty

Abstract

Purpose: In our study, we aimed to present our nine-year pediatric keratoplasty (KP) experience in a tertiary hospital with indications, surgical techniques and visual results. Methods: Pediatric patients who underwent KP surgery between 2012 and 2021 in our department were retrospectively analyzed. Patients' gender, age at transplantation, indications, surgery technique, combined surgeries, best corrected visual acuity (BCVA), intraocular pressure (IOP), spherical equivalent (SE) values, postoperative complications and follow-up times were evaluated. Surgical success was considered as an IOP <22 mmHg with or without additional surgery, improvement or preservation of visual acuity. Results: 72 eyes of 63 patients were included in the study. Twenty (31.7%) of the patients were female and 43 (68.3%) were male. There were keratoconus in 46 (63.9%) eyes, corneal scarring in 21 (29.2%) eyes, corneal dystrophy in 4 (5.6%) eyes, and corneal abscess in 1 (1.4%) eye. The mean age of transplantation was 14.03(4-17) years, and the follow-up period was 47.8(6-124) months. Recurrent KP surgery was performed in 1 (1.4%) patient due to graft failure. Preoperative BCVA was 1.13±0.64 logMaR, and postoperative BCVA was 0.45±0.63 logMaR (p<0.01). There were 65 (90%) eyes with a final BCVA of 20/200 or better, and 46 (64%) eyes with a final BCVA of 20/40 or better. Postoperative mean SE was 1.87±3.87 diopters. In 10 patients, higher IOP was detected in the postoperative controls, and trabeculectomy was performed in 2 patients. Conclusion: After long-term follow-up of our patients, we achieved a vision of 20/200 or better in 63%. Although pre- and post-operative management is quite difficult in pediatric KP cases, long-term visual results can be satisfactory in correctly selected cases.

Keywords

References

  1. 1. Beauchamp GR. Pediatric keratoplasty: problems in management. J Pediatr Ophthalmol Strabismus. 1979;16:388-94. DOI: 10.3928/0191-3913-19791101-13.
  2. 2. Vanathi M, Panda A, Vengayil S, et al. Pediatric keratoplasty. Surv Ophthalmol. 2009;54(2):245-71. DOI: 10.1016/j.survophthal.2008.12.011.
  3. 3. Gulias-Cañizo R, Gonzalez-Salinas R, Hernandez-Zimbron LF, et al. Indications and outcomes of pediatric keratoplasty in a tertiary eye care center: A retrospective review. Medicine (Baltimore). 2017;96:e8587. DOI: 10.1097/MD.0000000000008587.
  4. 4. Stulting RD, Sumers KD, Cavanagh HD, et al. Penetrating keratoplasty in children. Ophthalmology. 1984;91:1222-30. DOI: 10.1016/s0161-6420(84)34171-9.
  5. 5. Cowden JW. Penetrating keratoplasty in infants and children. Ophthalmology. 1990;97:324-8. DOI: 10.1016/s0161-6420(90)32586-1.
  6. 6. Mun-Wei L, Md Said H, Punitan R, et al. Indications, Clinical Outcomes, and Survival Rate of Pediatric Penetrating Keratoplasty in Suburban Malaysia: A 10-year Experience. Cureus. 2018;10:e3744. DOI: 10.7759/cureus.3744.
  7. 7. Dada T, Sharma N, Vajpayee RB. Indications for pediatric keratoplasty in India. Cornea. 1999;18:296-8. DOI: 10.1097/00003226-199905000-00009.
  8. 8. Dana MR, Schaumberg DA, Moyes AL, et al. Outcome of penetrating keratoplasty after ocular trauma in children. Arch Ophthalmol. 1995;113:1503-7. DOI: 10.1001/archopht.1995.01100120033003.

Details

Primary Language

English

Subjects

Ophthalmology

Journal Section

Research Article

Authors

Early Pub Date

December 13, 2024

Publication Date

January 1, 2025

Submission Date

August 2, 2023

Acceptance Date

January 28, 2024

Published in Issue

Year 2025 Volume: 16 Number: 1

DOI

https://doi.org/10.31067/acusaglik.1336571

IZ

https://izlik.org/JA62AT72WU

Cite

RIS / Bibtex
EndNote
Yaprak L, Çetinkaya Yaprak A, Başol İ, Ünal M, Ayaz Y (January 1, 2025) Indications, Surgical Techniques and Visual Outcomes of Pediatric Keratoplasty. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 16 1 78–82.