J Korean Ophthalmol Soc > Volume 54(5); 2013 > Article
Journal of the Korean Ophthalmological Society 2013;54(5):704-708.
DOI: https://doi.org/10.3341/jkos.2013.54.5.704    Published online May 15, 2013.
Clinical Outcomes of Penetrating Keratoplasty in Patients Five Years or Younger.
Yong Woo Kim, Hyuk Jin Choi, Mee Kum Kim, Won Ryang Wee, Young Suk Yu, Joo Youn Oh
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. jooyounoh77@gmail.com
2Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
전층각막이식술을 받은 5세 이하 환아들의 수술 성적
Department of Ophthalmology, Seoul National University College of Medicine1, Seoul, Korea
Seoul National University Hospital Healthcare System Gangnam Center2, Seoul, Korea
To investigate the clinical outcomes of primary pediatric keratoplasty. METHODS: Records of patients who underwent penetrating keratoplasty at the age of 5 years or younger were retrospectively reviewed. The survival rates of corneal grafts, postoperative complications, and causes of graft failure were evaluated. RESULTS: A total of 31 penetrating keratoplasties were performed in 29 patients, two of which were bilateral. The mean follow-up period was 78.72 +/- 8.94 months. The overall graft survival rate was 51.61%. The graft survival rate was 77.4% at 6 months, 61.3% at 12 months, 57.5% at 2 years, and 49.5% at 5 years after the surgery (the median survival time, 39.2 months). The main surgical indications included sclerocornea (35.5%), followed by Peter's anomaly (25.8%) and congenital glaucoma (9.7%). There were significant differences in graft survival time among the surgical indications, of which sclerocornea was the worst (p = 0.003). The main cause of graft failure was rejection (46.7%), followed by infection (26.7%) and primary endothelial decompensation (20%). When patients were sub-grouped according to age (under 12 months, between 12 to 48 months, and over 48 months), there was significant difference in graft survival time (p = 0.037) but not in overall graft survival rate (p = 0.154). Graft rejection occurred more frequently in patients between 12 to 48 months of age compared to other age groups (p = 0.016). Three out of 13 graft infections occurred in patients under 12 months of age. CONCLUSIONS: The type of disease causing corneal opacity was a significant factor affecting the clinical outcomes of penetrating keratoplasty in children.
Key Words: Graft survival time;Penetrating keratoplasty

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