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. 1997 Dec;81(12):1064-9.
doi: 10.1136/bjo.81.12.1064.

Transplantation of congenitally opaque corneas

B E Frueh  1 , S I Brown
Affiliations

Transplantation of congenitally opaque corneas

B E Frueh et al. Br J Ophthalmol. 1997 Dec.

Abstract

Aims: To assess retrospectively the prognosis and complications of corneal grafting for congenital opacities.

Methods: Fifty eight eyes of infants and young children with congenital corneal opacities were studied retrospectively. Preoperative diagnoses included sclerocornea (27 eyes), Peters' anomaly (17 eyes), partial sclerocornea (12 eyes), and congenital glaucoma (two eyes). Penetrating keratoplasty was performed between 5 days and 65 months of age with a mean follow up of 40 (SD 29) months.

Results: The overall success (including regrafts) was 70% in eyes with sclerocornea, 83% for partial sclerocornea, and 100% for Peters' anomaly. However, 23 eyes had to be regrafted between 2 weeks and 110 months postoperatively. The probability of maintaining a clear graft, calculated by survival analysis, was 75% (SE 6%) at 1 year and 58% (7%) at 2 years for the entire group. Complications included cataract development (12 eyes), secondary glaucoma (14 eyes), epithelial defects (six eyes), band keratopathy (five eyes), retinal detachment (three eyes), wound leakage (two eyes), retrocorneal membrane (one eye), and microbial keratitis (two eyes).

Conclusions: It is concluded that corneal grafting for congenital opacities in infants has an excellent potential for long term survival and should be performed as early as possible for unilateral as well as bilateral involvement. The postoperative course is complex and often requires regrafting.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curves of graft survival for the first, second, and third penetrating keratoplasty. The symbols represent end of follow up.
Figure 2
Figure 2
Kaplan-Meier survival curves for the first grafts, presented by different diagnostic groups. Congenital glaucoma (two eyes) have been excluded.
Figure 3
Figure 3
Kaplan-Meier survival curves of grafts with and without lensectomy and anterior vitrectomy at first surgery. Mantel-Haenszel approach showed a significant difference in graft survival between the two groups (p=0.018).
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