[The indications and prognosis of penetrating keratoplasty in 236 children].
OBJECTIVE
To evaluate indications, surgical details, factors affecting graft survival and determinants of visual acuity after penetrating keratoplasty (PKP) in children.


METHODS
This was a retrospective analysis of 266 grafts of PKP performed in 257 eyes of 236 children, aged younger than 14 years between June 1994 and June 2004 in Shandong Eye Institute and Qingdao Eye Hospital. The patient characteristics, indications, and outcome with follow up 6 months to 9 years and 5 months, mean (21 +/- 13) months were evaluated.


RESULTS
On the basis of the corneal pathology, the indications of pediatric PKP were divided into three categories: related to congenital, hereditary and growth (99 eyes, 38.5%), related to trauma (82 eyes, 31.9%) and related to keratitis (76 eyes, 29.6%). At the last follow-up, the best corrected visual acuity of 146 eyes were better than 0.05, 37.7% (55/146) of these eyes were related to keratitis, and 55.5% (81/146) aged more than 9 years; 190 (190/266, 71.4%) of total grafts remained clear, in which, 52 (52/73, 71.2%) grafts were related to additional surgical procedures remained clear, 24 (24/48, 50.0%) were bilateral grafts and 8 (8/21, 38.1%) were repeat grafts. There was no significant difference between only PKP and PKP additional surgical procedures (chi(2) = 0.002, P = 0.965), and there was significant difference between the unilateral and bilateral grafts (chi(2) = 13.178, P = 0.000), between once and repeat PKP (chi(2) = 12.413, P = 0.000).


CONCLUSIONS
The indications related to congenital, hereditary and growth are the main cause of pediatric PKP. The outcome is concerned with indications, ages onset, additional surgical procedures, bilateral grafts, and so on. Pediatric PKP is of benefit to children avoiding blindness caused by corneal opacity, especially combined with pre- and post-operative care.
Xie
Li-xin
LX
Shandong Eye Institute, Qingdao Eye Hospital, Qingdao 266071, China. lixinxie@public.qd.sd.cn
Ma
Lin
L
Dong
Xiao-guang
XG
Shi
Wei-yun
WY
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000151:congenital / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D015948:Keratoplasty, Penetrating; D011379:Prognosis; D012189:Retrospective Studies