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Glaucoma a risk factor for corneal graft failure in pediatric patients
Cornea. 2009;28(9):1003-1008.
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Penetrating keratoplasty in pediatric patients has a fair overall prognosis but pre- or postoperative glaucoma may increase the likelihood of graft failure.
According to a retrospective chart review of 106 PKs performed in 47 patients, overall graft survival at 1 year was 54%. There was no difference in survival rate according to surgical indication, and survival rates were similar among different age groups.
However, "patients with glaucoma are at high risk for graft failure, with 1-year survival of approximately 30%," the study authors said. Even in eyes with medically controlled glaucoma before transplant, the graft survival rate was significantly lower at 1 year than in eyes without glaucoma, 31% vs. 70%, respectively.
At the time of final follow-up, a median of 4.4 years, 57 of 60 eyes had a recorded visual acuity; 53% had vision of counting fingers or better and 47% had nonambulatory vision. In addition, 39% of these eyes had undergone a repeat corneal transplant, and about 42% of 60 primary grafts overall subsequently required repeat transplantation.
"None of the eyes requiring repeat grafts achieved a vision better than 20/400 during their last follow-up visit," the authors said.