First Report Of Keratoplasty For Pediatric Keratoconus In A Tertiary Center In Morocco: A Pilot Study
Published 2025 - 43rd Congress of the ESCRS
Reference: PP14.17 | Type: Poster | DOI: 10.82333/7dg6-7v15
Authors: Chaimae Zaid* 1 , Boutaina Bousselam 2 , Hibatallah Daoui 2 , Lalla Ouafa Cherkaoui 1 , Mohammed Belmekki 2
1Ophtalmologie-A-CHUIS-Med V University,Rabat,Morocco, 2Cheikh Zaid Hospital-Abulcasis University,Rabat,Morocco
Purpose
Pediatric keratoconus is more severe and has a faster deteriorating course when compared to adults’onset keratoconus. It is known to be a challenging disease for the physician with a major social-impact for the young patients. Our under-resourced setting in Morocco lacks data about disease progression and a management algorithm adapted to our setting. Various studies addressed CXL in PKC but only few had reported corneal grafting.Our study aimed to explore real-world practice of corneal grafting for managing PKC in under-resourced setting. We also focus on increasing awareness on the impact of recruiting patients at earlier stages of their disease to further assess the feasibility of mass screening.
Setting
This real-world pilot study was conducted as exploratory in the department of Ophthalmology of the International University Hospital Cheikh Zaid which is a tertiary eye care center in Rabat, Morocco. Data were collected retrospectively in June-July 2021, March 2022 and May 2023.
Methods
Our pilot study included 60 patients under 15 years old who underwent keratoplasty for PKC. Demographics, clinical characteristics, management and graft survival were analyzed.
Included patients should have the following criteria: (a)age of 15 years old (legal threshold for pediatric care in Morocco) or less at the time of surgery, (b)corneal grafting for keratoconus on one or both eyes.
Results
51.7% of our patients were males with a median age at surgery of 13 years (IQR: 3). Known risk factors for KC were widely reported. Deep anterior lamellar keratoplasty was performed in 56.5% of cases and penetrating keratoplasty in 43.5%.
After a median follow-up of 28.8 months (IQR: 29.3), the complications were reported in 38.7% (N=24) of study population. Median graft survival of our study population was 51.45 months (95% CI 33.55-69.35). Sex ,age, keratoplasty type, median travel distance did not affect graft survival rates (p>0.05).
Conclusions
Our study shed light on important features of the management of this aggressive disease in our setting including late diagnosis, younger age of study population and more importantly the grafting was performed as a salvage procedure.
This pilot study was intended to be a preliminary study to provide a rational for a further prospective study with large enrolment and hypothesis testing focusing on mass screening