[Experience in penetrating keratoplasty in children: graft survival, functional results and risk factors].
Penetrating keratoplasty in children is related with a labor-consuming process of follow-up and care as well as with a high risk of graft rejection and a moderate vision improvement. Nonetheless, keratoplasty has been and still remains a surgery of choice due to a lack of an alternative procedure; its technique and results have been gradually promoted in practice. The authors analyzed 112 keratoplasties in childhood-age corneal opacifications of different types. The graft survival amounted to 71%, 61% and to around 55% after 1, 2 and 5 postoperative years, respectively. Neovascularization, glaucoma, repeated keratoplasty, an original vitreous pathology, an expanded surgical scope (reconstructions) etc. were attributed to risk factors. The visual acuity improved by more than 0.02 in 54% of cases; it remained unchanged or worsened in 22% of cases and it could not be assessed in 24% of cases. The best results were achieved in a group of patients with acquired corneal opacifications of the nontraumatic nature; the worst results were observed in congenital anomalies of the anterior eye segment. Finally, the success of penetrating keratoplasty in children was ensured through a careful selection of patients, an accurate surgical technique and through a fast treatment of postoperative complications.
Khvatova
A V
AV
Pleskova
A V
AV
D000367:Age Factors; D000869:Anterior Eye Segment / Q000002:abnormalities; D002648:Child; D002675:Child, Preschool; D003318:Corneal Opacity / Q000601:surgery; D005260:Female; D005901:Glaucoma / Q000151:congenital / Q000601:surgery; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007634:Keratitis / Q000601:surgery; D015948:Keratoplasty, Penetrating; D008297:Male; D018579:Patient Selection; D011182:Postoperative Care; D011183:Postoperative Complications; D012086:Reoperation; D012307:Risk Factors; D012737:Sex Factors; D014019:Tissue Donors; D014792:Visual Acuity; D014821:Vitrectomy