Visual Outcomes Of Pediatric Corneal Transplantation In A Developing Country

To assess visual results in pediatric patients after penetrating corneal trasplantation. To determine post operative complication rate and identify clinical and demographic characteristics of the population studied.

National Ophthalmology Unit, Roosevelt Hospital, Guatemala City, Central America

Retrospective chart review of paients from 0 to 12 years old who underwent corneal transplant from Jan 2017 to Dec 2022. Charts reviewed for demographic data, preoperative diagnosis, pre and post operative visual acuity and complications. Best-corrected visual acuity (BCVA) was measured in LogMar. Pearson chi-square test, Fishers's exact and variance analisis were used with significance defined as p<0.10.  

Twenty three eyes of twenty three patients under 12 years old underwent penetrating keratoplasty from Jan 2017 to Dec 2022, average follow up was 34 months. 
Mean age was 6.57 years (SD+/- 4.11) 78% were males. The preoperative diagnosis were infectious keratitis (39%), keratoconus (22%), congenital disease (22%) and trauma (17%). BCDVA improved in 74% of eyes. Complications were reported in 22% of eyes, the most frecuent complication was infectious keratitis  (60%). Graft rejection were reported in 2 cases (8.7%). There was not statistical relation between BCDVA and variables studied.

In a national reference center of a low income country, corneal trasplantation in pediatric population presented improvement in BCDVA and low profile of complication rate. These results suggest that infectious keratitis is the main cause of corneal transplantation in pediatric population and also the most frequent cause of post operative complications. Graft rejection was a rare complication and was not associated to a specific preoperative etiology. Pediatric corneal transplantation seems to be an effective and safe procedure but more patient data and prospective clinical trials are needed, along with long term follow-up.