Other tissuePediatric Penetrating Keratoplasty: Indications and Outcomes
Section snippets
Methods
In this retrospective study, the records of 16 cases of pediatric penetrating keratoplasty (15 patients) were reviewed between January 2003 and December 2008. The patients underwent surgery in Hedi Rais Institute of Ophthalmology (Department B). By reviewing the patients' medical records, history, clinical examination results, clinical and pathological diagnoses, and outcomes of keratoplasty of each patient was gathered. Follow-up data were collected until 3 years postoperatively (mean
Results
A total of 16 eyes from 15 pediatric patients up to 14 years of age underwent penetrating keratoplasty and were enrolled in this 5-year study. The median age at surgery was 11.2 years. Patients' age ranged from 3 to 14 years. Both eyes were operated in one case. The gender distribution involved 67% (n = 10) boys and 33% (n = 5) girls.
The classification by Stulting et al1 was used to group the participants into nontraumatic, acquired traumatic, and congenital indications. The acquired
Discussion
The cornea in children is more flexible and less rigid than in adults. Examinations before and after operation, medical treatments, and nursing procedures are all more difficult in children than in adults. Because of the anatomical and physical characteristics of a child's sclera, the crimpling of the eyeball during operation, forward displacement of the lens and iris diaphragm, as well as synechia, often occur in pediatric keratoplasty. The majority of infants and young children are hyperopic,
Conclusion
Our series shows that prolonged corneal graft survival can be achieved in childhood among patients grafted for either congenital or acquired causes of corneal opacity. Amblyopia and postoperative astigmatism were thought to be responsible for poor vision in the majority of clear grafts. Intensive amblyopic therapy may promote visual recovery.
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