Outcomes of Corneal Transplant in Childhood Glaucoma.

Abstract

Childhood glaucoma produces alterations of the postnatal development and function of various ocular structures, including the cornea. Childhood glaucoma patients present lower corneal transplant survival rates. Our series shows clinical outcomes of corneal transplant in childhood glaucoma, with 29. To investigate the surgical outcome of different types of keratoplasty in eyes with childhood glaucoma. A retrospective review was made of the medical records from 17 eyes of 15 patients who were diagnosed with childhood glaucoma and received a corneal transplant between January 2010 and July 2020. Patient demographics, intraocular pressure (IOP), previous ocular surgery, comorbidities, corneal transplant surgery and follow-up outcome were collected. The primary efficacy end point was graft survival (in months) until failure, the latter being considered as irreversible loss of corneal transparency. Secondary efficacy points were need for an increase in topical hypotensive therapy and need for additional surgery. Seventeen eyes of fifteen patients were included, eleven eyes (ten patients) with primary congenital glaucoma (PCG) and six with other types of childhood glaucoma. Corneal transplant was performed at the mean age of 23.76±14.86 years. At the time of the transplant, the number of topical medications was 1.35±1.27, IOP was 15.00±8.34mmHg and patients had received up to seven glaucoma surgeries. Descemet Stripping Automated Endothelial Keratoplasty was performed in thirteen eyes (76%) and penetrating keratoplasty in four (24%). After surgery, seven (41%) eyes required increased topical treatment and two (12%) glaucoma surgery. Twelve eyes (71%) developed graft failure at 24 months, the mean time of survival being 13.88±8.25 months. Management of corneal decompensation in childhood glaucoma poses a challenge. In this series of childhood glaucoma with corneal transplants, survival rate was 29% at 24 months.