Oversized grafts in children

Ophthalmology. 1999 Apr;106(4):829-32. doi: 10.1016/S0161-6420(99)90174-4.


Objective: To evaluate the efficacy of oversized corneal grafts in the pediatric age group.

Design: Prospective, nonrandomized clinical trial.

Participants and intervention: Forty pediatric patients with unilateral or bilateral corneal opacification of congenital or acquired origin underwent corneal grafting surgery over a period of 2 years using donor corneal buttons oversized by 1 mm.

Main outcome measures: The parameters evaluated were indications for keratoplasty, graft clarity, visual acuity, keratometry, spherical equivalent, anterior chamber depth, and complications.

Results: Corneal ulceration was the most common cause of corneal opacification (25%), followed by trauma (20%) and sclerocornea (20%). At 1 year, clear grafts were achieved in 85% of the cohort. The average keratometry at the end of 1 year was 43.28 +/- 1.65 diopters (D) in the congenital opacity group and 43.04 +/- 2.20 D in the acquired group. The keratometric astigmatism was 3.60 +/- 2.60 D in the congenital group and 2.52 +/- 2.20 D in the acquired group. Oversized grafts provided an adequate anterior chamber depth of 2.20 +/- 0.612 mm in the congenital group and 2.36 +/- 0.302 mm in the acquired group. Visual acuity of 20/80 or better was recorded in only 30% of cases in the congenital group as opposed to 47% with acquired opacities. Nine cases had episodes of graft rejection.

Conclusion: Oversizing donor buttons by 1 mm provides adequate anterior chamber depth and increases the morphologic success of corneal grafting in children.

Publication types

  • Clinical Trial

MeSH terms

  • Anterior Chamber / anatomy & histology
  • Child
  • Child, Preschool
  • Corneal Opacity / diagnosis
  • Corneal Opacity / surgery*
  • Corneal Transplantation / methods*
  • Female
  • Graft Survival / physiology
  • Humans
  • Infant
  • Male
  • Postoperative Complications
  • Prospective Studies
  • Visual Acuity / physiology