Combined Keratoplasty With Vitreoretinal Procedures In Paediatric Population- Indications And Outcome

Combined surgeries involving keratoplasty with vitroretinal procedures in paediatric population is rare and usually follows trauma. We reviewed case records  over a 1 year period  to understand corneal, retinal indications , anatomic  and functional outcomes in these eyes.

Retrospective case series 

Medical records of  patients who underwent  combined  keratoplasty with vitreoretinal procedures in the pediatric age group with a minimum  postoperative follow up of 6 months were reviewed

Mean age was 8.25 years. Commonest indication was corneal trauma (5),  of which 4 underwent   therapeutic corneal transplantation   for  endophthalmitis while one underwent optical along with  VR procedure. In the remaining 3 patients , optical PK was combined with RD surgery(sclerocornea 1, congenitial glaucoma 1 )  while 1 patient with congenital glaucoma underwent PK with ERM removal. At  final follow up, 5 out of the 8 eyes were lost to phthisis ( 3  post TPK, 1 congenital glaucoma and 1 post traumatic ). 2 grafts  failed while one had  moderate clarity, all with attached retina. In 3 of the  4 eyes where in preoperative visual acuity could be recoded, improvement was noted while one was lost to pthysis.

Indications for combined PK VR  procedures  in paediatric age group quite often follows trauma. Final outcome and prognosis is influenced by  ocular comorbidities