Deep Anterior Lamellar Keratoplasty in Children

Ashar, Jatin; Pahuja, Shivani; Ramappa, Muralidhar; Vaddavalli, Pravin K.; Chaurasia, Sunita; Garg, Prashant

doi:10.1016/j.ajo.2012.09.029

Cited by 52 publications

(25 citation statements)

References 24 publications

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“…In a large Australian series of PK, only half those done in infants and 20% of those done at age 5–12 years failed 19. Our results also compare poorly with a recent Indian series of DALK 20. Eighteen grafts in 26 children (69%) in this series were clear at final follow-up, although the distribution of follow-up is not clear.…”

Section: Discussioncontrasting

confidence: 88%

Structural and functional outcomes of anaesthetic cornea in children

et al. 2014

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Section: Discussioncontrasting

confidence: 88%

Structural and functional outcomes of anaesthetic cornea in children

et al. 2014

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“…To date, several efforts have been made to improve visual and functional outcomes in children, and although keratoplasty remains the surgery of choice for the management of pediatric corneal disease incurable by medical treatment, some authors have proposed other approaches. Among these, contact lens wear in selected corneal opacities, [ 7 ] use of keratoprosthesis, [ 8 ] as well as different surgical techniques like rotational autokeratoplasty [ 9 , 10 ] and deep anterior lamellar keratoplasty (DALK) [ 11 – 13 ] have been proposed; the former restricted only for specific cases, and the latter with unclear long-term results and not suitable for all patients. [ 14 ] Regarding keratoplasty, most authors agree that smaller grafts and interrupted single sutures may improve postoperative outcome in children.…”

Section: Introductionmentioning

confidence: 99%

Indications and outcomes of pediatric keratoplasty in a tertiary eye care center

et al. 2017

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To evaluate indications and outcomes of pediatric keratoplasty in a tertiary eye center, and identify factors that affect visual outcomes.We performed a retrospective review of penetrating keratoplasty in children aged 0 to 18 years between 1995 and 2011 in the Asociación para Evitar la Ceguera en México IAP, Hospital “Dr. Luis Sánchez Bulnes”.A total of 574 penetrating keratoplasties were performed during the study interval. Median follow-up was 5.0 years. Main indications included keratoconus (55.58%), postherpetic scarring (9.58%), traumatic opacities (7.49%), and bullous keratopathy (6.09%). Rejection rates at 5 years were 27% overall, and among indications, keratoconus showed the best graft survival at 60-months follow-up (85%). The percentage of patients with best corrected visual acuity (BCVA) posttransplant >20/400 at 5 years in the nonrejection group was 81.25% and 82.74% in < and > 10 years of age (YOA) groups, respectively, versus a BCVA posttransplant > 20/400 at 5 years in the rejection group of 53.68% and 51.72% in < and > 10 YOA groups, respectively. There was a statistically significant reduced rejection rate between genders at 18 months of follow-up, favoring males.Despite being considered a high-risk procedure in children, penetrating keratoplasty can achieve good results, especially in patients with keratoconus. It can achieve significative improvements of visual acuity, provided there is an adequate follow-up and treatment adherence.

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“…In the larger of the series, Ashar et al 24 reported on 26 eyes in a cohort without any patients with MPS. BB was attempted in seven cases but only successful in three, and manual dissection was used in the remaining eyes.…”

Section: Discussionmentioning

confidence: 97%