Characterization of Pediatric Keratoplasty

Authors

Keywords:

cornea, keratoplasty, pediatric patient.

Abstract

Introduction: The World Health Organization reports that more than eight million individuals worldwide lose their vision due to corneal opacities; 1.5 million of them are children. Objective: To describe the characteristics of keratoplasty in pediatric patients at Ramón Pando Ferrer Cuban Institute of Ophthalmology from 1998 to 2019. Methods: A descriptive, observational and cross-sectional study was carried out. The sample consisted of 239 eyes of 209 patients, between 1 and 18 years old, who underwent pediatric keratoplasty. Demographic, clinical and surgical variables were studied. Results: During the study period, an average of 6.25 pediatric keratoplasties were performed for every hundred patients operated on. The average age was 10.3 years. Males predominated (67.5%) and unilateral surgery (96.7%). Acquired corneal opacity was the most frequent indication for keratoplasty, and within this, corneal leucoma and keratoconus. Transplant rejection was the most common cause of corneal regraft. Keratoplasties for optical purposes (87.9%), penetrating keratoplasties (88.3%) and those that did not require simultaneous intraocular surgery (76.6%) prevailed. Conclusions: Although pediatric keratoplasty represents an uncommon procedure and subject to debate, it is crucial in the treatment of both congenital and acquired corneal diseases. Its main objective is to improve visual function in pediatric patients, which underlines its relevance in ophthalmologic clinical practice.

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References

1. Maharana PK, Nawaz S, Singhal D, Jhanji V, Agarwal T, Sharma N, et al. Causes and Management Outcomes of Acquired Corneal Opacity in a Preschool Age (0-5 Years) Group: A Hospital-Based Study. Cornea. 2019;38(7):868-72. DOI: https://doi.org/10.1097/ICO.0000000000001962

2. Mathews PM, Lindsley K, Aldave AJ, Akpek EK. Etiology of Global Corneal Blindness and Current Practices of Corneal Transplantation: A Focused Review. Cornea. 2018;37(9):1198-203. DOI: https://doi.org/10.1097/ICO.0000000000001666

3. Solebo AL, Teoh L, Rahi J. Epidemiology of blindness in children. Arch Dis Child. 2017;102(9):853-7. DOI: https://doi.org/10.1136/archdischild-2016-310532

4. Hashemi H, Pakzad R, Yekta A, Khabazkhoob M. The Prevalence of Corneal Opacity in Rural Areas in Iran: A Population-based Study. Ophthalmic Epidemiol. 2018;25(1):21-6. DOI: https://doi.org/10.1080/09286586.2017.1337912

5. Mohamadmehdi S, Abolhosseini M, Kheiri B, Ali Javadi M, Ziaee Ardakani L, Rezaei Kanavi M. Eye Bank Records on Pediatric Keratoplasty. J Ophthalmic Vis Res. 2022;17(3):324-37. DOI: https://doi.org/10.18502/jovr.v17i3.11569

6. Moreno Ramirez ME, Pérez Parra Z, León Rodríguez Y, Brizuela Concepción Y, Castillo Borges YM. Opacidades corneales en niños. Rev Cubana Oftalmol. 2022 [acceso 13/09/2022];35(3). Disponible en: https://revoftalmologia.sld.cu/index.php/oftalmologia/article/view/1581

7. Nieves-Moreno M, Yeo D, Patel HI, Reddy MA. The frequency of severe corneal opacities in premature infants. J AAPOS. 2021;25(4). DOI: https://doi.org/10.1016/j.jaapos.2021.03.013

8. Liu S, Wong YL, Walkden A. Current Perspectives on Corneal Transplantation. Clin Ophthalmol. 2022;16:631-46. DOI: https://doi.org/10.2147/OPTH.S289359

9. Alio JL, Montesel A, El Sayyad F, Barraquer RI, Arnalich-Montiel F, Alio Del Barrio JL. Corneal graft failure: an update. Br J Ophthalmol. 2021;105(8):1049-58. DOI: https://doi.org/10.1136/bjophthalmol-2020-316705

10. Lowe MT, Keane MC, Coster DJ, Williams KA. The outcome of corneal transplantation in infants, children, and adolescents. Ophthalmology. 2011;118(3):492-7. DOI: https://doi.org/10.1016/j.ophtha.2010.07.006

11. Moreno Ramírez ME, Pérez Parra Z, López Hernández S, Castillo Pérez A. Indicaciones de la queratoplastia pediátrica en Cuba: Estudio de 15 años. Rev Cubana Oftalmol. 2016 [acceso 15/04/2024];29(1):40-8. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762016000100005

12. López Hernández S, Moreno Ramírez ME, Escalona Leyva E, Castillo Pérez A, Pérez Parra Z, Márquez Villalón S, et al. Queratoplastia: Características clínicas y evaluación de resultados. Rev Cubana Oftalmol. 2008 [acceso 15/04/2024];21. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762008000100008&nrm=iso

13. Pérez Parra Z, Jareño Ochoa M, Fernández García K, Casas Arias X, Noriega Martínez JL, Fuentes González M. Seguridad de la queratoplastia lamelar anterior profunda versus queratoplastia penetrante en el tratamiento del queratocono. Rev Cubana Oftalmol. 2020 [acceso 15/04/2024];33. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762020000100005&nrm=iso

14. Pérez Parra Z, Moreno Ramírez ME, Jareño Ochoa M, Castillo Pérez AC, Charles Elizondo A, Moya Pérez J. Resultados visuales en pacientes operados de queratoplastia lamelar anterior profunda versus queratoplastia penetrante en el queratocono. Rev Cubana Oftalmol. 2020 [acceso 15/04/2024];33. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762008000100008&nrm=iso

15. Escalona Leyva ET, Pérez Parra Z, López Hernández SM, Zaldívar Hernández H. Queratoplastia lamelar predescemética para el tratamiento del queratocono. Rev Cubana Oftalmol. 2014 [acceso 15/04/2024];27:576-86. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762000000100006&nrm=iso

16. Moreno Ramirez ME, Pérez Parra Z, Casas Arias X, Jareño Ochoa M, Castillo Pérez AC. Glaucoma y queratoplastia pediátrica. Rev Cubana Oftalmol. 2022 [acceso 15/04/2024];35(4). Disponible en: https://revoftalmologia.sld.cu/index.php/oftalmologia/article/view/1581

17. Hovlykke M, Hjortdal J, Ehlers N, Nielsen K. Clinical results of 40 years of paediatric keratoplasty in a single university eye clinic. Acta Ophthalmol. 2014;92(4):370-7. DOI: https://doi.org/10.1111/aos.12198x

18. Velásquez-Monzón K, Navarro-Peña MC, Klunder-Klunder M, Tsatsos M, Ramírez-Ortiz MA. Pediatric penetrating keratoplasty and graft rejection: experience at the Hospital Infantil de México Federico Gómez. Bol Med Hosp Infant Mex. 2020;77(1):23-7. DOI: https://doi.org/10.24875/BMHIM.19000070

19. Gulias-Canizo R, Gonzalez-Salinas R, Hernandez-Zimbron LF, Hernandez-Quintela E, Sanchez-Huerta V. Indications and outcomes of pediatric keratoplasty in a tertiary eye care center: A retrospective review. Medicine (Baltimore). 2017;96(45). DOI: https://doi.org/10.1097/MD.0000000000008587

20. Mun-Wei L, Md Said H, Punitan R, Ibrahim M, Shatriah I. Indications, Clinical Outcomes, and Survival Rate of Pediatric Penetrating Keratoplasty in Suburban Malaysia: A 10-year Experience. Cureus. 2018;10(12). DOI: https://doi.org/10.7759/cureus.3744

21. Fouzdar-Jain S, Ibrahim Z, Reitinger J, Cao D, Mocan MC. Visual Outcomes in Pediatric Patients with Peters Anomaly. Clin Ophthalmol. 2021;15:2591-6. DOI: https://doi.org/10.2147/OPTH.S302299

22. Osorio M, Restrepo A, Solano Franco AA. Resultados visuales y sobrevida de injerto obtenidos en una población pediátrica sometida a queratoplastia. Rev Soc Colomb Oftalmol. 2018 [acceso 13/09/2022];51(1):72-8. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7025786

23. Lin Q, Shi W, Miao S, Zhang Y, Li L, Pan Z. Visual Outcomes and Prognostic Factors of Successful Penetrating Keratoplasty in 0-to 7-Year-Old Children with Congenital Corneal Opacities. Cornea. 2018;37(10):1237-42. DOI: https://doi.org/10.1097/ICO.0000000000001689

24. Gallo Borrero DE, Letfor Allen S. El trauma ocular en la infancia. Rev Cubana Oftalmol. 2019 [acceso 15/04/2024];32. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762019000300005&nrm=iso

25. Pohlmann D, Rossel M, Salchow DJ, Bertelmann E. Outcome of a penetrating keratoplasty in a 3-month-old child with sclerocornea. GMS Ophthalmol Cases. 2020;10. DOI: https://doi.org/10.3205/oc000162

26. Krachmer JH, Mannis MJ, Holland EJ. Cornea. Fundamentals, Diagnosis and Management. 3 ed. Philadelphia: Elsevier; 2011. p. 1455-72.

27. Wan X, Yao W, Zhao S, Xu J, Le Q. Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study. J Ophthalmol. 2021;2021. DOI: https://doi.org/10.1155/2021/5514004

28. Zhu AY, Marquezan MC, Kraus CL, Prescott CR. Pediatric Corneal Transplants: Review of Current Practice Patterns. Cornea. 2018;37(8):973-80. DOI: https://doi.org/10.1097/ICO.0000000000001900

Published

2025-02-24

How to Cite

1.
Moreno Ramírez ME, Pérez Parra Z, López Hernández SM, Castillo Pérez A de la C, Rodríguez Rodríguez B. Characterization of Pediatric Keratoplasty. Rev Cubana Pediatría [Internet]. 2025 Feb. 24 [cited 2025 Jun. 25];97. Available from: https://revpediatria.sld.cu/index.php/ped/article/view/7276