ESCRS - PP14.01 - Clinical Outcomes And Graft Survival Of Keratoplasty Pkp And Lkp For Patients With Down Syndrome At King Khaled Eye Specialist Hospital

Clinical Outcomes And Graft Survival Of Keratoplasty Pkp And Lkp For Patients With Down Syndrome At King Khaled Eye Specialist Hospital

Published 2026 - 44th Congress of the ESCRS

Reference: PP14.01 | Type: Poster | DOI: 10.82333/ayg7-na18

Authors: Dr Thamer Abdullah Alanazy* 1 , Dr Rawan Alshabeeb 1 , A/Prof. Ali Alrajhi 1

1ophthalomogy,king khaled eye sepcialsit hospital,Riyadh,Saudi Arabia

Purpose

Down syndrome is one of the most prevalent genetic disorders in the world, An estimated One in 400 to 1500 live births affected by Down syndrome.

The incidence of keratoconus was observed to range from 0 to 32% in the studies that particularly looked at children with Down syndrome (10). The incidence is as high as 71.3% in Adult with Down syndrome (11). It is commonly known that keratoplasty  is a very effective treatment for keratoconus in the general population. 

 

purpose : To determine the short term and long term graft survival rate, penetrating keratoplasty (PKP) and lamellar Keratoplasty (LKP ) in patients with keratoconus and Down Syndrome

Setting

Tertiary Eye centre -King Khaled eye specialist hospital , Riyadh, saudi Arabia . 

Methods

Retrospective study 

The medical records of patient with down syndrome and keratoconus and underwent Keratoplasty has been reviewed .Clincial data including patients demographics ,surgical procedure and post operative course has been collected .

 

-        Patients with Down syndrome (clinically and genetically confirmed )  keratoconus ( based on clinical exam and Topography/ tomography parameters )  who underwent keratoplasty at KKESH

 

 

-        Inclusion Criteria : All age group of Patient with Down syndrome  and severe keratoconus who underwent keratoplasty for keratoconus at KKESH between November 1983 -January 2025

Results

The study included 29 patients (30 eyes, one patient with bilateral keratoplasty) .  Postoperative complications included suture-related microbial keratitis in 5 eyes (16.7%), graft rejection in 4 eyes (13.3%), glaucoma in 2 eyes (6.6%), neovascularization in 20 eyes (66.7%), and graft dehiscence in one patient . Seven patients (23.3%) required two or more examinations under anesthesia. At final follow-up, 26 grafts (86.7%) remained clear, while 4 (13.3%) failed, with a mean postoperative VA of 0.98 ± 0.70 LogMAR .There were no serious ocular or systemic adverse events.Graft failure was slightly higher common in PKP compared to LKP, but the difference was not statistical significance (p = 0.079).
 

Conclusions

Primary keratoplasty in patients with Down syndrome provides favorable outcomes with improved visual acuity and  manageable complications Both LKP and PKP were safely performed under general anesthesia, indicating that timely surgical intervention provides significant visual rehabilitation in this population.