Penetrating keratoplasty in children: visual and graft outcome

Aims: To review factors affecting graft survival and determinants of visual acuity after penetrating keratoplasty in children. Methods: All cases of penetrating keratoplasty performed in an ophthalmic unit, in children aged less than 15 years at the time of operation, for the period 1984 to 2002 were included. Results: 19 penetrating keratoplasties were done in 18 eyes of 16 children, age range 2 weeks to 14 years 8 months (mean 9.24 years), with mean follow up 6.6 years. 73.7% of grafts have remained clear for up to 14 years. Postoperative visual acuity among congenital indications for graft was better than 6/60 in only 14.2% of cases, but was better than or equal to 6/12 in all cases of keratoconus. Conclusion: This series shows that prolonged corneal graft survival can be achieved in children, but successful restoration of visual acuity depends upon a period of normal visual development before the onset of corneal opacification.