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Corneal transplants in children with glaucoma have high risk of failure

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BRASILIA — Despite a 70% improvement in visual acuity, corneal transplants in children with glaucoma have a high risk of failure, according to a surgeon speaking here. Controlling IOP postoperatively is also difficult, she noted.

Maria Emília Xavier S. Araújo, MD, won the Southeast prize of the Brazilian Congress of Ophthalmology for her presentation on a study of 18 eyes in 14 children treated from 1996 to 2003. The children ranged in age from 5 months to 84 months and were followed for up to 52 months postop.

Visual acuity improved in most patients. However, ocular hypertension was a complication in all eyes, with patients requiring up to two additional glaucoma drugs to control IOP. Two patients also required implantation of drainage tubes, Dr. Araújo said.

The corneal transplant was rejected in 22% of eyes, she noted.

"We may not have had total control preoperatively because patients were referred," she said.

Dr. Araújo suggested that all patients be implanted with a drainage tube before the corneal transplant, which has been shown to improve success rates in studies of adult patients.