Antonio Di Zazzo1, Stefano Bonini2, Salvatore Crugliano3, Michele Fortunato4. 1. IRCCS G.B. Bietti Foundation ONLUS, via Livenza n.3, 00198, Rome, Italy. Antonio_dizazzo@yahoo.com. 2. Department of Ophthalmology, University Campus Bio-Medico of Rome, Rome, Italy. 3. Humanitas Group, Mater Domini Hospital, Castellanza, Italy. 4. IRCSS Bambino Gesù Pediatric Hospital, Rome, Italy.
Abstract
PURPOSE: Pediatric keratoplasty is an immense challenge because of the technical complexity of the procedure and the high risk of rejection in young graft recipients. Our aim is to describe the major indications and appropriate timing of corneal transplantation intervention, including a report of our experience and surgical tips, in conjunction with the current literature. METHODS: Review of the literature on indications for keratoplasty in pediatric patients classified as: congenital, traumatic and acquired non-traumatic opacities. We additionally explored the challenges corneal surgeons face in performing this type of surgery and review the most pressing transplant-related problems and their management. RESULTS: Outcomes after pediatric keratoplasty, in terms of visual development, restoration and clarity of the graft, are influenced by peri-operative local and systemic conditions and factors, and by intraoperative management of the transplantation procedure itself. CONCLUSION: Pediatric corneal transplantation is a critical tool for visual restoration and development in young patients with corneal opacities, particularly during the critical period of visual development. Successful management of the significant challenges associated with pediatric keratoplasty requires customized clinical and surgical management of each patient with particular attention paid to proper post-operative rehabilitation.
PURPOSE: Pediatric keratoplasty is an immense challenge because of the technical complexity of the procedure and the high risk of rejection in young graft recipients. Our aim is to describe the major indications and appropriate timing of corneal transplantation intervention, including a report of our experience and surgical tips, in conjunction with the current literature. METHODS: Review of the literature on indications for keratoplasty in pediatric patients classified as: congenital, traumatic and acquired non-traumatic opacities. We additionally explored the challenges corneal surgeons face in performing this type of surgery and review the most pressing transplant-related problems and their management. RESULTS: Outcomes after pediatric keratoplasty, in terms of visual development, restoration and clarity of the graft, are influenced by peri-operative local and systemic conditions and factors, and by intraoperative management of the transplantation procedure itself. CONCLUSION: Pediatric corneal transplantation is a critical tool for visual restoration and development in young patients with corneal opacities, particularly during the critical period of visual development. Successful management of the significant challenges associated with pediatric keratoplasty requires customized clinical and surgical management of each patient with particular attention paid to proper post-operative rehabilitation.
Authors: Seyed Mohamadmehdi Moshtaghion; Mohammad Abolhosseini; Bahareh Kheiri; Mohammad Ali Javadi; Leila Ziaee Ardakani; Mozhgan Rezaei Kanavi Journal: J Ophthalmic Vis Res Date: 2022-08-15