Keratoprosthesis in high-risk pediatric corneal transplantation: first 2 cases.

Infantswithsignificantcornealopacitiesareat risk fordevelopmentofprofound deprivation amblyopia without surgical intervention. Early cornealtransplantationisrecommended. However, penetrating keratoplasty (PK) in young children is considered a high-risk procedure. Additionally, apoorerprognosishasbeendescribed in children with congenital corneal opacities when compared with acquired corneal opacities. Allograft rejection is the cause in the great majority of pediatric graft failures. Implantationofakeratoprosthesis, orasyntheticcornea, isconsideredfor patientswhoareathighriskfordonor cornealtransplantations.Althoughsignificant early and late postoperative complicationscanoccur, favorableresults have been achieved in patients witharelativelyhealthyocularsurface, such as in cases with multiple immunologic graft failures. To date, keratoprosthesis implantation has been exclusively performed in adult patients. The success in children is unknown. Owing to the poor survival rate of conventional corneal transplantations in this group, we performed keratoprosthesis implantation in 2 infants with congenital corneal opacities and glaucoma to overcome deprivation amblyopia. In this article, we describe our short-term results.