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Asim Ali, Uri Elbaz, Kamiar Mireskandari; Long term corneal endothelial cell counts following early paediatric keratoplasty. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1554.
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© ARVO (1962-2015); The Authors (2016-present)
To report long term endothelial cell counts after paediatric keratoplasty within the first year of life.
The charts of all children that have undergone penetrating or endothelial keratoplasty between January 1999 to December 2013 at the Hospital for Sick Children were reviewed retrospectively. Only patients that had corneal transplant within the first year of life and had a valid endothelial cell count post-surgery were included in the study. Donor endothelial cell counts were provided by a local eye bank. Post-operatively specular microscopy images were taken using a noncontact specular microscope. In small children specular microscopy images were taken in the lateral decubitus position under general anesthesia.
Twenty eyes of 13 patients were included in the study. Mean patient age at time of surgery was 2.6±1.5 months (1.3-6.8 months) and mean follow-up time was 49.2±42.6 months (6-143 months). Eighteen eyes have undergone penetrating keratoplasty (PKP) and two eyes of the same patient have undergone endothelial keratoplasty (EK). Six eyes had additional intraocular surgeries post-transplant. The mean donor size was 6.8±1.0 mm (5.0-8.5 mm). The mean endothelial cell count pre-keratoplasty and at last follow-up was 3045±438 cells/mm2 (2625-4083 cells/mm2), and 1514±692 cells/mm2 (693-2203 cells/mm2), respectively, reflecting 49.9±22.5 % (26.0-77.5%) endothelial cell loss (ECL).
Paediatric keratoplasty has higher ECL compare to the reported adult ECL following penetrating keratoplasty. Whether this is related to the smaller size donor graft or to the more challenging surgical and anatomical properties of pediatric keratoplasty merits more investigation.
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