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Curr Opin Ophthalmol. 2017 Sep;28(5):477-484. doi: 10.1097/ICU.0000000000000393.

Pediatric corneal transplants.

Author information

1
aDepartment of Ophthalmology, Columbia University Medical Center, New York, New York, USA bDepartment of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, Sao Paulo, Sao Paulo, Brazil cCornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania dWilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.

Abstract

PURPOSE OF REVIEW:

Pediatric keratoplasty poses unique challenges in clinical and surgical management. However, successful transplantation can afford a child vision in an otherwise poorly seeing eye. This review will provide an update on recent advances in pediatric keratoplasty.

RECENT FINDINGS:

Although children who receive corneal transplants remain at increased risk of rejection, infection, and graft dehiscence compared with adult corneal transplant recipients, new surgical techniques, and advances in clinical management have led to better outcomes. Surgical modifications in penetrating keratoplasty (PKP) offer increased stabilization of the delicate pediatric eye. Lamellar surgery, including endothelial keratoplasty and deep anterior lamellar keratoplasty, can target specific diseased tissue in children with potentially fewer complications. The keratoprosthesis can be used successfully in children when the chance of success with PKP is especially low.

SUMMARY:

As our knowledge of prognostic indicators and surgical techniques continues to grow, we can offer children safer and more targeted surgeries for some of the most challenging corneal diseases. Ultimately, successful transplantation with long-term graft survival can be obtained by a multidisciplinary approach, with care across ophthalmic specialties, and a commitment to long-term follow-up by the patient's family.

PMID:
28505034
DOI:
10.1097/ICU.0000000000000393
[Indexed for MEDLINE]

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