Indications and Outcomes of Penetrating Keratoplasty in Infants and Children of Beijing, China.

PURPOSE: To retrospectively investigate the indications and outcomes of pediatric penetrating keratoplasty (PKP) and to explore factors that affect graft survival.

METHODS

Patients who had undergone PKP from May 2010 to December 2016, aged ≤12 years were categorized as infants (≥3 months and <4 years) or children (≥4 years and ≤12 years). Clinical data including patient demographics, indications, surgical procedures, postoperative follow-up, and graft clarity were recorded and analyzed.

RESULTS

Among 160 eyes of 146 patients, 79 eyes and 81 eyes were treated from the infant and child groups, respectively, and followed up for 33.7 ± 21.7 months (range, 6 months to 7 years). The most common indication for PKP was congenital corneal opacity (71.9%). The survival rate of all corneal grafts was 68.1%. The rejection reaction rate was 33.8%. More children than infants underwent PKP that was combined with other intraocular surgeries (P < 0.05). The graft failures were in the regraft (52.0%), congenital opacities (30.4%), and acquired opacities (15.0%) groups. The rate of graft failure in patients who received PKP combined with other intraocular surgery (40.0%) was higher than those who received PKP only (30.0%). The univariate logistic regression analysis revealed that the graft failure was associated with the graft indication (P < 0.05).

CONCLUSIONS

The most common indication for PKP in children younger than 12 years was congenital corneal opacity in Beijing, China. The graft survival was 68.1%, with a mean follow-up of 33.7 months. Graft failure was associated with the indication.