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M. Rodriguez, R. Velasco, O. Baca, D. Viggiano, M. Calvillo; Results of Penetrating Keratoplasty in Children . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5043.
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Purpose: To evaluate the visual outcome of penetrating keratoplasty in children. Methods: A retrospective study was made. All patients younger than 12 years old who underwent penetrating keratoplasty were included. Preoperative and postoperative visual acuity (uncorrected and best corrected),postoperative graft clarity and complications were studied. Patients were divided into three groups according to the etiology: group 1: congenital, group 2: acquired non traumatic and group 3: traumatic. Donor cornea data (age, cell density and size) were recorded from Central Florida Lions Eye and Tissue Bank, Inc. Variables of the receptor were taken from the charts. We divided patients into three groups according to the cause of failure:.Group A primary graft failure, Group B graft rejection and Group C Secundary failure. Results: Thirty four cases were studied. The follow up period was 26 months in average. One case (2.9%) was in group 1, 23 cases (67.6%) in group 2 and 10 cases (29.4%) in group 3. Twenty cases (58.8%) were clear at the end of follow up. Fourteen cases ( 41.1%) failed. One case (0.7%) was in group A, 3 cases (21.4%) in group B and 10 cases (71.4%) in group C. Postoperative complications were present in 14 cases (41.1%), and 6 cases underwent additional noncorneal surgical procedures. Cases with previous multiple procedures like vitrectomy, lensectomy or regraft were associated with failure in 100% of cases. Preoperative visual acuity was between light perception (LP) to count fingers (CF) in 100% of cases, Postoperative visual acuity was LP – CF in 34%, 20/200 – 20/80 in 42% and 20/70 – 20/40 in 24% of cases. Conclusions: Keratoplasty in the pediatric group is a high risk procedure, in this study the secundary graft failure was the most frequent cause of failed, the visual outcome is related with preoperative diagnosis, age, regraft and multiple surgical procedures.
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