results of pediatric penetrating keratoplasty in labafinejad medical center: 2001-2012

purpose: to report the outcomes of pediatric penetrating keratoplasty (pk) performed in labafinejad medical center, a tertiary referral ophthalmology center, between 2001 and 2012. methods: in this retrospective interventional case series, medical records of all pediatric patients (age≤12 years) who underwent primary pk were reviewed. age at the time of surgery, indications for keratoplasty, postoperative uncorrected visual acuity (ucva) and best spectacle-corrected visual acuity (bscva), postoperative refractive error, graft rejection episodes, graft clarity at the final follow-up, cause of graft failure and secondary intervention were reported. cumulative graft survival was calculated using kaplan-meier method. results: the study was conducted on 54 eyes of 45 children (27 males) including unilateral pk in 36 cases and sequential bilateral pk in 9 patients. surgical indications were congenital hereditary endothelial dystrophy (ched, n= 17; 31.5%), trauma (n=6; 11.1 %), keratoconus (n=9; 16.7%), anterior segment dysgenesis (n=8; 14.8%), corneal perforation (n=8; 14.8%), corneal scars (n=4; 7.4%) and aphakic bullous keratopathy (n=2; 3.7%). cumulative graft survival for 6 months, 1, 2 and 3 years were 74%, 68%, 65% and 62%, respectively. this rate was 61% at mean follow-up of 59 months. the graft survival was highest in old corneal scar and keratoconus (100% clear at month 60) followed by ched (82.3% at month 61). the worst outcome was observed in traumatic cases (16.6% at month 9) conclusion: pediatric pk yielded the best results when the indications were keratoconus and old corneal scar followed by ched. the worst prognosis was observed in eyes with a history of trauma having led to vitreoretinal surgery and anterior segment dysgenesis.