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Factors predicting graft failure of paediatric penetrating keratoplasty in southern Tunisia

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First Author: M.Rekik TUNISIA

Co Author(s):    M. Rekik   S. Kammoun   M. Loukil   S. Ben Amor   A. Trigui   J. Feki     

Abstract Details

Purpose:

The penetrating keratoplasty in children has specific indications and problems. The complications represented mainly by graft rejection, remain an important cause of therapeutic failure. The aims of this study were to determine the incidence of graft failure in pediatric keratoplasty, analyze the causes of failure according to the age of the patients and preoperative indications and to evaluate the risk factors for Failure in Sfax, in southern Tunisia.

Setting:

Department of Ophthalmology, Habib Bourguiba University Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia.

Methods:

We undertook a retrospective review of 40 primary penetrating keratoplasty performed in 37 children and adolescents 18 years of age or younger in our department between January 2004 and December 2015.

Results:

Mean age was 12 years (1 to 18 years). Surgical indications were congenital opacities (23%), acquired non-traumatic opacities (65%) and acquired post traumatic opacities (12%). Keratoconus was the most common diagnosis (53%). Overall graft survival rate was 67% at one year. The best corneal graft survival was found in acquired non-traumatic opacities (77%) and adolescents (79%) (p <0.0001). Graft rejection was the leading cause of failure (77%). Risk factors for graft rejection included history of intraocular surgery, combined surgery, corneal neovascularization, intraocular inflammation, and surgery after keratoplasty.

Conclusions:

Graft survival vary by indication and recipient age. Corneal grafts for keratoconus in adolescents show excellent survival. Successful transplantation requires careful preoperative evaluation, rigorous follow-up, and aggressive postoperative treatment and cooperating parents.

Financial Disclosure:

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