Oversized grafts in children.
OBJECTIVE
To evaluate the efficacy of oversized corneal grafts in the pediatric age group.


METHODS
Prospective, nonrandomized clinical trial.


METHODS
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.


METHODS
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.


CONCLUSIONS
Oversizing donor buttons by 1 mm provides adequate anterior chamber depth and increases the morphologic success of corneal grafting in children.
Vajpayee
R B
RB
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
Ramu
M
M
Panda
A
A
Sharma
N
N
Tabin
G C
GC
Anand
J R
JR
D000867:Anterior Chamber / Q000033:anatomy & histology; D002648:Child; D002675:Child, Preschool; D003318:Corneal Opacity / Q000175:diagnosis / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology