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G. W. Zaidman, A. Garcia; The Long-Term Outcome of Corneal Transplant Surgery in Juvenile Keratoconus. Invest. Ophthalmol. Vis. Sci. 2009;50(13):621.
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To determine the long-term course of children who require corneal transplant surgery for keratoconus.
We performed a retrospective analysis of all children, under 18 years old, that underwent penetrating keratoplasty for keratoconus since 1997
15 patients were analyzed. There were 8 boys and 7 girls. The average age of the patients was 15.2 years, ranging from 11 to 18. Thirteen patients had bilateral disease. Three had had hydrops. 20 eyes required transplant surgery. The average time between first consultation and surgery was 0.9 years, ranging from 0.2 to 10.6 years. There were 6 episodes of graft rejection; 5 cleared and one graft failed. Five of the rejection episodes occurred within the first year after transplant surgery; the sixth occurred within 2 years after surgery. There were no other complications. In the 19 eyes with clear grafts, 17 had a corrected visual acuity > 20/40. 10 of these are better than 20/25. 2 patients have irregular astigmatism and have a vision of 20/50.
Children who require penetrating keratoplasty for keratoconus usually do well. There is a 30% incidence of graft rejection but most clear. 85% of the patients obtained exellent vision.
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