Paediatric keratoplasty: choices and conundrums: Table 1

Medsinge, Anagha; Nischal, Ken K.

doi:10.1136/bjophthalmol-2013-303469

Cited by 15 publications

(3 citation statements)

References 23 publications

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“…Among these, contact lens wear in selected corneal opacities, [ 7 ] use of keratoprosthesis, [ 8 ] as well as different surgical techniques like rotational autokeratoplasty [ 9 , 10 ] and deep anterior lamellar keratoplasty (DALK) [ 11 – 13 ] have been proposed; the former restricted only for specific cases, and the latter with unclear long-term results and not suitable for all patients. [ 14 ] Regarding keratoplasty, most authors agree that smaller grafts and interrupted single sutures may improve postoperative outcome in children. [ 15 , 16 ] Nevertheless, these efforts have not been limited to the selection and performance of the most adequate technique.…”

Section: Introductionmentioning

confidence: 99%

Indications and outcomes of pediatric keratoplasty in a tertiary eye care center

et al. 2017

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To evaluate indications and outcomes of pediatric keratoplasty in a tertiary eye center, and identify factors that affect visual outcomes.We performed a retrospective review of penetrating keratoplasty in children aged 0 to 18 years between 1995 and 2011 in the Asociación para Evitar la Ceguera en México IAP, Hospital “Dr. Luis Sánchez Bulnes”.A total of 574 penetrating keratoplasties were performed during the study interval. Median follow-up was 5.0 years. Main indications included keratoconus (55.58%), postherpetic scarring (9.58%), traumatic opacities (7.49%), and bullous keratopathy (6.09%). Rejection rates at 5 years were 27% overall, and among indications, keratoconus showed the best graft survival at 60-months follow-up (85%). The percentage of patients with best corrected visual acuity (BCVA) posttransplant >20/400 at 5 years in the nonrejection group was 81.25% and 82.74% in < and > 10 years of age (YOA) groups, respectively, versus a BCVA posttransplant > 20/400 at 5 years in the rejection group of 53.68% and 51.72% in < and > 10 YOA groups, respectively. There was a statistically significant reduced rejection rate between genders at 18 months of follow-up, favoring males.Despite being considered a high-risk procedure in children, penetrating keratoplasty can achieve good results, especially in patients with keratoconus. It can achieve significative improvements of visual acuity, provided there is an adequate follow-up and treatment adherence.

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Section: Introductionmentioning

confidence: 99%

Indications and outcomes of pediatric keratoplasty in a tertiary eye care center

et al. 2017

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“… 26 Although DSAEK has several advantages, due to the irregularity of the interface, the optical clarity might be inferior to PKP. 88 , 89 Ramappa et al reported 10-year outcomes of DSAEK in 180 pediatric eyes and found improved and safe outcomes with this technique. 90 …”

Section: Congenital Opacitiesmentioning

confidence: 99%

Pediatric corneal transplantation: techniques, challenges, and outcomes

Gurnani,

Kaur,

Chaudhary

et al. 2024

Ophthalmol Eye Dis

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Pediatric corneal transplant is a highly demanding and technically challenging procedure for the cornea surgeon in today’s era. These cases pose unique challenges in clinical and surgical management. The indications of pediatric corneal transplant can be therapeutic, tectonic, optical, and cosmetic. Pediatric patients undergoing corneal transplants are at a high risk of graft infection, failure, rejection, dehiscence, and amblyopia due to young age, robust immune system, increased incidence of trauma, and compliance issues. The other factors contributing to graft failure can be allograft rejection, secondary glaucoma, corneal vascularization, multiple surgeries, vitreous prolapse, and lack of treatment compliance. A successful corneal transplant in children depends on meticulous preoperative evaluation, uneventful surgery, the expertise of a corneal surgeon, and regular and timely postoperative follow-up. Therapeutic and optical penetrating keratoplasty are the most commonly performed transplants in children. However, with the advancements in surgical technique and management protocol, the current focus has shifted toward lamellar keratoplasty. Lamellar keratoplasty offers early visual recovery and potentially fewer complications. Visual rehabilitation through corneal transplant in otherwise blind eyes can be a boon for the children. Recently, keratoprostheses have been promising in children with multiple graft failures. The current review gives insights into epidemiology, etiology, indications, clinical characteristics, investigations, management options, recent advances, and the future of pediatric corneal transplants. As surgical techniques continue to grow and comprehension of pediatric corneal transplants is improving, we can safeguard these eyes with the best possible anatomical and functional outcomes.

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“…12 It is also worth noting that the majority of patients reported by Areaux and colleagues 3 had Peters' anomaly, for which DSEK may not be appropriate. 13 Thus, PK for infants may be with us for some time yet.…”

mentioning

confidence: 99%

Keratoplasty in infancy: how early is early?

Lyons

2020

Journal of American Association for Pediatric Ophthalmology and

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Paediatric keratoplasty: choices and conundrums: Table 1

Cited by 15 publications

References 23 publications

Indications and outcomes of pediatric keratoplasty in a tertiary eye care center

Indications and outcomes of pediatric keratoplasty in a tertiary eye care center

Pediatric corneal transplantation: techniques, challenges, and outcomes

Keratoplasty in infancy: how early is early?

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