The Impact of Socioeconomic Factors on Pediatric Keratoplasty Outcomes: A Decade of Our Experience at a Tertiary Eye Care Center in South India.

PURPOSE: The objective of this study is to report the impact of social and demographic factors on pediatric keratoplasty outcomes at a tertiary care center in India. We explore nonclinical factors that may influence outcomes to optimize surgical success and visual acuity in pediatric patients.

METHODS

We conducted an observational, cross-sectional study of patients aged 16 years or younger who underwent keratoplasty at a single institution in South India. A total of 255 participants were interviewed with their families in person or by telephone using a voluntary, institutional review board-approved electronic survey. Demographic data were self-reported, and participants' aggregate clinical outcomes were obtained through chart review. Primary outcome measures were graft clarity and functional vision at the final follow-up.

RESULTS

Among 255 participants, 137 (53.7%) had bilateral congenital corneal disease. The mean duration of follow-up was 74.4 ± 47.1 months, during which 184 patients (72.2%) achieved clear grafts in operated eyes. Multivariate analysis revealed significant associations between surgical success and type of surgery (Category 1 P = 0.001; Category 2 P = 0.006) and government support (Category 1 P = 0.006; Category 2 P = 0.013). LogMAR visual acuity improved from 1.43 ± 0.54 before keratoplasty to 1.08 ± 0.73 at the last follow-up visit (P < 0.001).

CONCLUSIONS

Surgical success in pediatric keratoplasty is associated with demographic factors such as the father's education, consanguinity, and fewer financial dependents. These findings highlight the importance of health literacy and familial support in improving pediatric keratoplasty outcomes.