Pediatric penetrating keratoplasty: indications and outcomes

Transplant Proc. 2011 Mar;43(2):649-51. doi: 10.1016/j.transproceed.2011.01.055.


Purpose: This report evaluates patient characteristics, indications, and outcomes of pediatric keratoplasty, and identifies variables that help to predict poor surgical outcomes.

Methods: We undertook a retrospective review of all cases in our department of primary penetrating keratoplasty performed in children 14 years of age or younger between January 2003 and December 2009.

Results: Sixteen primary penetrating keratoplasties were performed during the study interval. Mean age was 11.2 years (3 to 14 years) and the gender ratio was 2. The mean duration of follow-up was 16 months (2 to 36 months).The surgical indications were acquired traumatic opacities in 6 cases, keratoconus in 5 cases, corneal perforation secondary to infectious keratitis in 3 cases, hereditary corneal dystrophy in 1 case, and acquired non-traumatic opacities secondary to congenital glaucoma in one case. The initial visual acuity was less than 1/20 in 68% of cases and the mean final visual acuity after 1 year was 2/10. The graft was clear in 52% of cases after 1 year of follow-up. Postoperative complications were graft failure (24%), ocular inflammation (5%), and ocular trauma (19%).

Conclusion: Penetrating keratoplasty in children has been documented to have a higher rate of graft failure and a worse visual prognosis than adult keratoplasty. Poor prognosis outcomes were especially caused by noncooperation of parents and postoperative ocular trauma.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Corneal Transplantation
  • Eye Diseases / therapy*
  • Female
  • Graft Rejection
  • Humans
  • Keratitis
  • Keratoplasty, Penetrating / methods*
  • Male
  • Postoperative Complications
  • Prognosis
  • Retrospective Studies
  • Sex Factors
  • Treatment Outcome