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Long-term outcomes in paediatric corneal transplants

Session Details

Session Title: Cornea Surgical II

Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30

Paper Time: 09:02

Venue: Forum (Ground Floor)

First Author: : A.Anshu SINGAPORE

Co Author(s): :    J. Low   H. Htoon   D. Tan        

Abstract Details

Purpose:

To evaluate long-term corneal graft survival and risk factors for failure in paediatric eyes.

Setting:

Singapore National Eye Centre, Singapore

Methods:

One hundred and eight patients aged 16 years and below were recruited from the ongoing prospective Singapore Corneal Transplant Study (SCTS) between April 1999 and 2011. Corneal graft survival was calculated using Kaplan-Meier survival analysis and log rank test. Potential risk factors were analyzed using univariate modelling.

Results:

The mean age of the patients was 8.22 (SD 5.7; range 0.18 – 15.92) years. . Indications for surgery were optical (68.5%), therapeutic (17.6%), tectonic (13.0%), and cosmetic (0.9%).45 (41.7%) eyes underwent penetrating keratoplasty (PK), 41 (38.0%) underwent anterior lamellar keratoplasty (ALK), and 22 (20.4%) underwent a lamellar corneal patch graft. Kaplan-Meier survival rates for PK was 92.8% at 1 year, 86.3% from 2-4 years, and 78.5% at 5 years; survival rates for ALK was 88.4% at 1 year, and 84.8% from 2 to 5 years; survival rates of corneal patch graft was 100% from 1 to 3 years and 90% at 4 and 5 years and this was not statistically significant (p = 0.39). Deep corneal vascularisation (p = 0.018), active inflammation (p = 0.034), ocular surface disease (p = 0.048), anterior vitrectomy (p = 0.001) and presence of glaucoma drainage device (p = 0.03) were found to be associated with reduced graft survival. Ocular surface disease (15.7%), glaucoma (13.9%) and late graft failure (6.5%) were the most common postoperative complications.

Conclusions:

The 5-year graft survival in paediatric eyes closely mirrors a previously published report from SCTS in non-paediatric grafts. Pre-existing deep corneal vascularization, active inflammation, ocular surface disease, and glaucoma drainage device and intra-operative anterior vitrectomy had an adverse effect on graft survival.

Financial Interest:

NONE