PURPOSE: The purpose of this study is to review the current literature on keratoprosthesis and its use in the pediatric population. METHODS: Case report and review of recent literature on outcomes of pediatric keratoplasty and keratoprosthesis. RESULTS: Penetrating keratoplasty in children is fraught with shortcomings, including difficulty maintaining a clear graft (as low as 44% at 50 months), poor visual acuity outcomes (only 30-34% achieving 20/400 or better), and a high rate of allograft rejection (40-50%). Placement of the Boston type I keratoprosthesis has the advantage of achieving a clear visual axis and stable refractive error within days of surgery without risk of rejection. However, life-long care is required, including topical steroids and antibiotic prophylaxis, as well as bandage contact lens wear and a frequent a need for further interventions for retroprosthetic membranes and glaucoma. CONCLUSIONS: With motivated parents, a successful anatomic and functional outcome can be achieved with the Boston keratoprosthesis in children of amblyogenic age.
PURPOSE: The purpose of this study is to review the current literature on keratoprosthesis and its use in the pediatric population. METHODS: Case report and review of recent literature on outcomes of pediatric keratoplasty and keratoprosthesis. RESULTS: Penetrating keratoplasty in children is fraught with shortcomings, including difficulty maintaining a clear graft (as low as 44% at 50 months), poor visual acuity outcomes (only 30-34% achieving 20/400 or better), and a high rate of allograft rejection (40-50%). Placement of the Boston type I keratoprosthesis has the advantage of achieving a clear visual axis and stable refractive error within days of surgery without risk of rejection. However, life-long care is required, including topical steroids and antibiotic prophylaxis, as well as bandage contact lens wear and a frequent a need for further interventions for retroprosthetic membranes and glaucoma. CONCLUSIONS: With motivated parents, a successful anatomic and functional outcome can be achieved with the Boston keratoprosthesis in children of amblyogenic age.
Authors: Kelley J Bohm; Alvaro Fernandez-Vega; Luis Acaba-Berrocal; R V Paul Chan; M Soledad Cortina Journal: Cornea Date: 2022-02-05 Impact factor: 3.152