Visual rehabilitation in children after penetrating keratoplasty

Session Details

Session Title: Surgical Cornea

Session Date/Time: Tuesday 25/09/2018 | 16:30-18:00

Paper Time: 17:48

Venue: Room A3, Podium 3

First Author: : F.Manurung INDONESIA

Co Author(s): :    M. Susiyanti                    

Abstract Details

Purpose:

To report our first results of Penetrating Keratoplasty (PK) and the visual outcome in the presence of various corneal abnormalities in children age < 2 years old in Jakarta Eye Center (JEC)

Setting:

Jakarta Eye Center, Indonesia

Methods:

All children < 2 years old referred by pediatric opthalmologist to undergo corneal transplantation by corneal surgeon between July 2014 – November 2017 were included. Data were collected retrospectively. Preoperative assesment includes slitamp handheld observation, corneal measurement, IOP measurement, B-scan ultrasonography and ERG-VEP. Visual acuity in preverbal children was measured by testing the ability to fix - follow light and object. At each postoperative visit in the office or under anaesthesia, visual acuity, IOP, slitlamp handheld observation to asses the condition of the graft and indirect opthalmoscopy or Retcam to asses the fundus were recorded.

Results:

PK were performed in 6 eyes from 5 patients (5 girls, age range 12 to 15 months). One case had secondary glaucoma due to rubella and congenital cataract with previous trabeculectomy on both eye and lensectomy on right eye. Two cases had unilateral corneal opacification. Three cases had bilateral corneal opacification (1 case PK has been done on both eyes). Age at the time of surgery range 14 to 22 months. Follow ups ranged from 1 to 32 months. Six eyes out of 6 grafts have remained clear, no sign of rejection and no sign of glaucoma or cataract.

Conclusions:

Early PK for congenital corneal opacities, even it is a high risk procedure especially in infants, can result in a clear corneal graft and may prevent deprivation amblyopia. PK on infant or child requires careful case selection, adequate preoperative evaluation, skilled surgery,very close cooperation family - physician, and intensive postoperative care and management of amblyopia to promote visual outcome.

Financial Disclosure:

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