The Outcomes of Primary Pediatric Keratoplasty in Singapore

Low, Jin Rong; Anshu, Arundhati; Tan, Anna; Htoon, Hla Myint; Tan, Donald

doi:10.1016/j.ajo.2014.05.020

Cited by 51 publications

(49 citation statements)

References 26 publications

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“…In a 20-year study conducted by Low et al investigating primary outcomes of pediatric keratoplasty; mean Kaplan–Meier graft survival for PK in Singaporean children was 171.7 months (95% CI 141.3–202.2). In this study, cases that underwent keratoplasty had long-term survival rate of 92.9% at 17 years [60]; however, this includes PK, ALK, lamellar corneal patch graft and DSAEK surgeries therefore is not representative of PK alone. Risk factors for corneal transplantation in pediatric keratoconus include young age of diagnosis, short duration of disease and steep keratometry values [3, 40].…”

Section: Results With Penetrating Keratoplastymentioning

confidence: 99%

“…High success is associated with PK in adult keratoconus; however, corneal transplantation carries poorer prognosis in children [1, 60]. Preoperative risk factors include difficult evaluation.…”

Section: Results With Penetrating Keratoplastymentioning

confidence: 99%

“…Graft failure is linked to preexisting active inflammation, a glaucoma drainage device, and/or ocular surface disease [60, 111]. Furthermore, complications from penetrating keratoplasty include deep corneal neovascularization, allograft rejection, trauma to anterior segment, infectious keratitis, epithelial defects, band keratopathy, wound leakage, retro-corneal membrane, cataract formation, secondary glaucoma and retinal detachment [37, 62, 110, 111], which too are important risk factors for graft rejection.…”

Section: Results With Penetrating Keratoplastymentioning

confidence: 99%

“…There are differing results between pediatrics and adults with regards to penetrating keratoplasties, with children having poorer outcomes, including higher graft failure rates and poorer visual prognosis [60–65]. …”

Section: Difference Between Adult and Pediatric Keratoconusmentioning

confidence: 99%

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Pediatric keratoconus: a review of the literature

2017

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Purpose To describe the epidemiology and prevalence, rates of progression, difference between adult and pediatric populations, and therapeutic approaches to pediatric keratoconus from documented literature. Methods A literature search was done on PubMed using key words including pediatric keratoconus, children with keratoconus, adult keratoconus, penetrating keratoplasty, corneal cross-linking and intra-corneal ring segments. The literature was reviewed and reported to explore the key epidemiological differences between the pediatric and adult population with regards to presentation and treatment options. Results Pediatric keratoconus is more aggressive than adult keratoconus, which has been explained by structural differences in the cornea between both populations. High rates of progression were documented in pediatric populations. While corneal collagen cross-linking, intracorneal ring segments and penetrating keratoplasties have been used as therapies in the pediatric population, the literature overwhelmingly shows higher rates of failure and progression despite these measures as compared to adults. Conclusion Pediatric keratoconus is more aggressive than adult keratoconus, and current therapies used in adults may not be sufficient for the pediatric population.

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Section: Results With Penetrating Keratoplastymentioning

confidence: 99%

Section: Results With Penetrating Keratoplastymentioning

confidence: 99%

Section: Results With Penetrating Keratoplastymentioning

confidence: 99%

Section: Difference Between Adult and Pediatric Keratoconusmentioning

confidence: 99%

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Pediatric keratoconus: a review of the literature

2017

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“…Penetrating keratoplasty or lamellar corneal transplantation commits a child and family to complex postoperative care and lifelong topical therapy, and has high risk of failure in infants. 7 Long-term graft survival and successful visual rehabilitation can occur with early surgery, aggressive amblyopia therapy, and strong commitment from caregivers for long-term follow up. 7 , 8 In this case the ocular surface stabilized with management as above and visual function was noted to improve.…”

Section: Discussionmentioning

confidence: 99%

Exposure, entropion, and bilateral corneal ulceration in a newborn as a manifestation of chromosome 22 q11.2 duplication syndrome

Moein

Saeed

Jacobs

et al. 2019

American Journal of Ophthalmology Case Reports

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PurposeChromosome 22q11.2 micro-duplication syndrome (MDS), is a rare autosomal dominant condition, with a highly variable phenotype that ranges from unremarkable and asymptomatic, to fatal due to cardiovascular defects. Hypertelorism, downslanting palpebral fissures, superior displacement of the eyebrows, and ptosis are the most commonly reported ocular manifestations. Here, we report a newborn with bilateral exposure, entropion, and corneal ulceration related to 22q11.2 MDS.ObservationA newborn girl presented with bilateral upper eyelid entropion, bilateral lower eyelid ectropion, and lagophthalmos. She subsequently developed bilateral corneal ulcers. Topical antibacterial drops, bandage contact lenses, medroxyprogesterone 1%, and fluorometholone 0.1%, together with partial tarsorrhaphy and correction of eyelid malposition, were used to treat the ulcers and address the underlying issues of exposure and entropion. Genetic testing revealed chromosome 22q11.2.MDS; further evaluation revealed systemic manifestations of this syndrome. The ocular surface healed well with gradual improvement of corneal opacification as well as bilateral partial tarsorrhaphy.Conclusion and importanceThis report is the first that describes a newborn with 22q11.2 MDS presenting with sight-threatening corneal ulceration. Entropion, ectropion, and lagophthalmos were identified and treated, allowing for healing of the corneal surface. Genetic testing revealed a syndrome not known to be associated with eyelid abnormalities and corneal ulceration, but with other important systemic and ocular implications. Bilateral partial tarsorrhaphy should not be excluded as a treatment option for infants who fail more conservative measures for the treatment of exposure.

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Surgical Considerations in Children with Corneal Opacities and Cataracts

Foster

Banitt

2018

Surgical Management of Childhood Glaucoma

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The Outcomes of Primary Pediatric Keratoplasty in Singapore

Cited by 51 publications

References 26 publications

Pediatric keratoconus: a review of the literature

Pediatric keratoconus: a review of the literature

Exposure, entropion, and bilateral corneal ulceration in a newborn as a manifestation of chromosome 22 q11.2 duplication syndrome

Surgical Considerations in Children with Corneal Opacities and Cataracts

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