Factors Associated with Corneal Graft Failure in Pediatric Keratoplasty

Abstract

Objective: To identify the factors associated with corneal graft failure in pediatric keratoplasty.

Methods: An explanatory, retrospective longitudinal descriptive observational study was carried out with pediatric patients operated on for keratoplasty. The sample consisted of 42 patients operated on for keratoplasty for optical purposes at Instituto Cubano de Oftalmología Ramón Pando Ferrer, between 1998 and 2019. Demographic, clinical and surgical variables were studied. The sample was divided into two groups: patients with corneal graft failure and patients without corneal graft failure.

Results: 57.1 % of the patients had graft failure with a mean age at the time of surgery lower than the nonfailure group. In both groups, there was a predominance of male patients and the acquired indication of origin as the cause of surgery. The most frequent indications in the graft failure group were corneal leukoma, rejection, sclerocornea and Peters anomaly; while, in the nonfailure group, they were keratoconus and corneal leukoma. There were statistical differences in patient age, preoperative corneal neovascularization, history of retransplantation, presence of graft sepsis, glaucoma and amblyopia, in relation to the occurrence of graft failure after keratoplasty for optical purposes.

Conclusions: The high frequency of graft failure in pediatric keratoplasty is associated with patient age, corneal neovascularization, retransplantation, postsurgical sepsis, and glaucoma.