Four years of corneal keratoplasty in Italian paediatric patients: indications and clinical outcomes

作者：Buzzonetti Luca^*; Ardia Roberta; Petroni Sergio; Petrocelli Gianni; Valente Paola; Parrilla Rosa; Iarossi Giancarlo

来源：Graefes Archive for Clinical and Experimental Ophthalmology, 2016, 254(11): 2239-2245.

DOI：10.1007/s00417-016-3447-2

• Paediatric keratoplasty
• Graft failure
• Penetrating keratoplasty
• Deep anterior lamellar keratoplasty

The purpose was to evaluate indications and clinical outcomes in paediatric corneal keratoplasty.
Fifty-four eyes of 43 patients who underwent corneal keratoplasty from the 1(st) of January 2010 through the 31(st) of December 2013 at the Bambino GesA(1) Children's Hospital in Rome, Italy, were retrospectively evaluated. To assess the effect of age on graft failure rate, the recipient age was considered as a dichotomous variable (aecurrency sign5 or > 5 years) and a 2X2 table was developed, using the chi-square test for testing the statistical significance. Furthermore, two separate subgroup analyses were conducted on patients of aecurrency sign5 years and those of > 5 years, to evaluate the effect of penetrating keratoplasty (PK) or deep anterior lamellar keratoplasty (DALK) on the graft failure rate. The level of statistical significance was set at p < 0.05
Mean recipient age was 8.9 +/- 5.7 [SD] years. Mean follow-up time was 22.8 months. Main preoperative diagnoses were keratoconus (37 %) and congenital glaucoma (20 %). Patients aecurrency sign5 years showed a higher percentage of graft failure (p = 0.0008). PK and DALK did not show statistically significant differences regarding the graft failure in both subgroups (p = 0.15 for aecurrency sign5 years group and p = 0.27 for > 5 years group, respectively). However, across groups DALK provided a lower rate of graft failure.
Our findings suggest that children older than 5 years show a significantly better graft outcome and that DALK seems to offer greatest benefits in terms of failure risk in paediatric patients.

• 出版日期2016-11