Primary pediatric keratoplasty: indications, graft survival, and visual outcome

Ali Al-Ghamdi; Ali Al-Rajhi; Michael D Wagoner

doi:10.1016/j.jaapos.2006.09.012

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Primary pediatric keratoplasty: indications, graft survival, and visual outcome

Journal article

Peer reviewed

Primary pediatric keratoplasty: indications, graft survival, and visual outcome

Ali Al-Ghamdi, Ali Al-Rajhi and Michael D Wagoner

Journal of AAPOS, Vol.11(1), pp.41-47

02/2007

DOI: 10.1016/j.jaapos.2006.09.012

PMID: 17307682

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Abstract

Penetrating keratoplasty in children has been documented to have a higher rate of graft failure and a worse visual prognosis than adult keratoplasty. We undertook a retrospective review of all cases of primary penetrating keratoplasty performed in children 12 years of age or younger at the King Khaled Eye Specialist Hospital between January 1, 1990, and December 31, 2003. One hundred sixty-five primary penetrating keratoplasties were performed in 134 children during the study interval. The surgical indications were congenital opacities in 130 eyes (78.8%), acquired, traumatic opacities in 18 eyes (10.9%), and acquired, nontraumatic opacities in 17 eyes (10.3%). Among congenital opacities, 35 cases were caused by congenital hereditary endothelial dystrophy (CHED). The median follow-up for 73 grafts (44.2%) that remained clear was 50 months (range, 12-50 months), whereas the median follow-up for 92 grafts (55.8%) that failed was 6 months (range, 1-54 months). Kaplan-Meier graft survival was significantly higher at all postoperative intervals in eyes with CHED than for other surgical indications (p < 0.001). Eyes with CHED were significantly more likely to achieve ambulatory vision or vision >20/200 than eyes with other indications (p < 0.001). Pediatric keratoplasty was associated with an excellent prognosis for graft survival in eyes with CHED and a fair prognosis for graft survival in eyes with non-CHED congenital opacities and acquired opacities. The best visual prognosis was obtained in eyes with CHED and the worst prognosis was for non-CHED congenital opacities.

Cornea - surgery

Prognosis

Follow-Up Studies

Eye Injuries - complications

Humans

Child, Preschool

Infant

Keratoplasty, Penetrating - methods

Corneal Opacity - surgery

Corneal Dystrophies, Hereditary - complications

Time Factors

Graft Survival - physiology

Corneal Opacity - etiology

Cornea - pathology

Retrospective Studies

Child

Visual Acuity - physiology

Corneal Injuries

Details

Title: Subtitle: Primary pediatric keratoplasty: indications, graft survival, and visual outcome
Creators: Ali Al-Ghamdi - Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
Ali Al-Rajhi
Michael D Wagoner
Resource Type: Journal article
Publication Details: Journal of AAPOS, Vol.11(1), pp.41-47
Publisher: United States
DOI: 10.1016/j.jaapos.2006.09.012
PMID: 17307682
ISSN: 1091-8531
eISSN: 1528-3933
Language: English
Date published: 02/2007
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983980004702771

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