Keratoplasty in children

Abstract

The authors report on indications, surgical techniques and results obtained in 37 children up to the age of 14 (42 eyes) on whom a total of 45 keratoplasties were performed. In 5 cases keratoplasties were performed on both eyes. The grafts remained clear in 26 eyes (58%); 8 grafts were moderately opaque and 11 (24%) were completely opaque. As expected, the best results were obtained in cases of keratoconus. The keratoplasties performed in late stages of herpetic keratitis with extensive corneal scarring and vascularization were a little less successful. Of 11 eyes thus treated, a final clear graft was achieved in 8. In cases with traumatic scars after severe eye injuries, the results were less satisfactory. The prognosis is poor in all severe dystrophic alterations of the cornea, and very bleak in the final stages of central abscess or ring abscess of the cornea. In a relatively high percentage, clear grafts contrast with poor postoperative visual acuity, which may be caused by a variety of complications. The most prominent complications were amblyopia, cataracta complicata and traumatica and aphakia. Thus, only 14 out of 26 eyes with clear grafts achieved a visual acuity in the range from 0.4 to 1.0.