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Pediatric keratoplasty: indications and outcomes

PURPOSE: To evaluate the indications and results after penetrating keratoplasty in children at Altino Ventura Foundation (FAV). METHODS: A retrospective study was performed in 33 patients (34 eyes), with ages equal or less than 12 years, they underwent a penetrating keratoplasty at FAV, from 2000 to 2009. The mean follow up time was 32.5 ± 23.1 months. Surgery indication, best corrected visual acuity (BCVA) before and after surgery, spherical equivalent (SE) pos surgical and complications were analyzed. The qualitative results were expressed by their frequencies and the quantitative by their means and standard deviations. The t-Student test was used to verify possible differences between means. The level of significance was 95.0% (p<0.05). RESULTS: Mean age at surgery was 7.5 ± 3.3 years. Twenty seven (79.4%) grafts had optical indication and seven (20.6%) therapeutic or tectonic. Among the optical transplants, the most frequent indication was cornea opacity after ocular trauma in 18 (52.9%) eyes. The visual acuity was better in 21 (61.7%) eyes and worse in eight (23.5%). In the optical transplants, rejection was present in four (14.8%) eyes, and four (11.8%) developed glaucoma. CONCLUSION: In FAV opacity after ocular trauma was the most common indication for pediatric keratoplasty. This may be the result of the low income and violent society, among the citizens from the studied population. Many blind children due to cornea disease may achieve improvement in visual acuity if an appropriate surgical and good postoperative management is performed.

Keratoplasty; Corneal transplantation; Child; Graft rejection; Glaucoma; Treatment outcome


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