Glaucoma and Pediatric Keratoplasty

Abstract

Introduction: The indication for keratoplasty in children, prognosis and risk factors associated with graft survival remain under discussion today.

Objective: To describe if there is a relationship between pre- and post-keratoplasty factors with the presence of pediatric glaucoma.

Methods: An observational, descriptive, longitudinal, retrospective study of case series was performed in patients who underwent keratoplasty in pediatric age. The variables studied were: age, gender, follow-up time, affected eye, preoperative ocular pathologic history, cause of keratoplasty, postoperative complications, time of graft failure, lines of sight gained, graft status, evisceration and use of ocular prosthesis.

Results: Twenty-four keratoplasty-operated eyes were studied in 22 patients under 18 years of age. The average age was 8.5 years and the average follow-up time was 8.1 years. One hundred percent of patients with glaucoma were less than 10 years of age; 80 percent of patients with congenital corneal opacity had glaucoma. Patients with preoperative glaucoma showed higher probability of ocular pressure decompensation after keratoplasty (83.3%), opaque graft (50%); in addition, amblyopia (83.3%) and low vision (66.6%) after keratoplasty.

Conclusions: The presence of preoperative glaucoma negatively influences pediatric keratoplasty outcomes. Future prospective studies are needed to further investigate the outcomes of keratoplasty in children and its risk factors for graft failure.