Long-Term Outcome of Long-Term Outcome of Corneal Transplant Surgery Corneal Transplant Surgery

in Pediatric Patients with in Pediatric Patients with KeratoconusKeratoconus

Anna Djougarian, MDHofstra / North Shore-LIJ Medical Center

Gerald Zaidman, MDWestchester Medical Center

Financial DisclosureFinancial DisclosureThe authors have no financial interests to disclose.

PurposePurposeTo investigate the outcome of corneal transplant surgery (CTS) in children with keratoconus (KCN).

MethodsMethodsFour years ago a retrospective chart review was conducted of all children under 18 years of age that had CTS for KCN from 2000-2008. This is a follow-up study and updated chart review of these patients. We are also presenting data on some new children who have had CTS for KCN since our last review.

ResultsResults• 31 eyes of 24 children had CTS.

• Mean age was 15.9 years, ranging from 11 to 18.

• 21(68%) had bilateral disease. 6 (19%) eyes had hydrops.

• Mean K at presentation was 55.2.

• Mean follow-up was 2.3 years, ranging from 0.02 years to 12.5 years.

ResultsResults• 30/31 eyes had clear grafts.

• 14/31 eyes had rejection episodes; 13 cleared.

• 1 eye had controlled glaucoma.

• No eyes had cataracts.

ResultsResults• BCVA Post-CTS

o 13/31 eyes ≥20/25o 28/31 eyes ≥20/40 o Of the remaining 3 eyes

with BCVA <20/40• 2 eyes (20/60 and

CF) were lost to follow-up less than 2 months following CTS

• 1 (20/100) blunt trauma

• BCVA Pre-CTSo 6 eyes 20/30-20/50o 6 eyes 20/60-20/100 o 9 eyes 20/150-20/400o 10 eyes ≤CF (of which, 6 eyes had hydrops)

ConclusionConclusion90% of pediatric patients with keratoconus did well following corneal transplant surgery with excellent visual recovery and few complications. There was a 45.2% incidence of graft rejection but nearly all cleared with medical therapy.