The outcome of corneal transplantation in infants, children, and adolescents

Ophthalmology
Marie T LoweKeryn A Williams

Abstract

To examine factors affecting penetrating corneal graft survival and visual outcomes in patients aged less than 20 years. Large prospective, cohort study. Records of 14 865 followed penetrating corneal grafts in 11 929 patients were searched to identify 765 grafts in 640 patients aged younger than 20 years of age at the time of graft. Records submitted to the Australian Corneal Graft Registry by 381 ophthalmic surgeons and 253 follow-up practitioners from May 1985 to June 2009 were analyzed using Kaplan-Meier survival plots and Cox proportional hazards regression analysis. Probability of corneal graft survival and Snellen acuity at the time of most recent follow-up and at defined intervals post-graft. Infants (<5 years) exhibited poorer graft survival than children aged 5 to 12 years. Adolescents (13-19 years) exhibited better corneal graft survival than other age groups; 86% of grafts in adolescents were for keratoconus. Factors significantly affecting corneal graft survival in pediatric patients included indication for graft, graft inflammation, history of intraocular surgery, vascularization, rejection episodes, post-graft operative procedures, and refractive surgery. Fourteen percent of pediatric grafts failed, of which 65% ...Continue Reading

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Related Concepts

Graft Survival
Keratoconus
Visual Acuity
Incidence Studies
Lamellar Keratoplasty
Kaplan-Meier Estimate
Corneal Perforation
Cox Proportional Hazards Models
Inflammation
Pathologic Neovascularization

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