Indications and Techniques of Pediatric Keratoplasty in Eastern China From 2008 to 2017

Purpose: To explore the transition of indications and surgical techniques of pediatric keratoplasty in Eastern China in the past 10 years. Methods: Medical charts of 1026 pediatric patients (1059 eyes) who underwent keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2008 to 2017 were retrospectively reviewed. The indications for keratoplasty and the surgical techniques were collected and analyzed. Results: A total of 634 infants (≤3 years) (661 eyes), 207 toddlers and older children (4–12 years) (211 eyes), and 185 adolescents (13–18 years) (187 eyes) were included. The median age at the time of surgery was 2 years. The surgical indications were composed of congenital abnormalities (74.6%), acquired nontraumatic diseases (16.5%), acquired traumatic diseases (3.6%), and regraft (5.3%). Only congenital abnormality had a significant growing trend during this decade (P = 0.023). Keratoconus (67.2%) exceeded infectious keratitis (14.9%) and was the most common acquired nontraumatic cause in our study. The annual number of pediatric keratoplasties increased significantly from 40 cases in 2008 to 190 cases in 2017 (P
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research

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Authors: Ghemame M, Charpentier P, Mouriaux F Abstract Developments in corneal topography allow for increasingly precise, detailed analysis of the corneal surface. This test is becoming indispensable in the treatment of complex corneas: keratoconus, corneal transplants, orthokeratology, etc. In refractive surgery, the combined analysis of the anterior and posterior cornea has permitted better screening for forme fruste keratoconus at risk for post-LASIK ectasia. Topography also assists in the calculation of premium intraocular lenses. Topography is an indispensable test for analyzing and following corneal disease. ...
Source: Journal Francais d Ophtalmologie - Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
Conditions:   Corneal Diseases;   Keratoconus;   Corneal Ulcer;   Corneal Trauma;   Corneal Dystrophies Intervention:   Sponsor:   University Hospital, Montpellier Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract OBJECTIVES: In recent years, there have been rapid advances in the field of keratoconus. Penetrating keratoplasty and deep anterior lamellar keratoplasty are the standard surgical procedures. Nevertheless, controversy remains regarding the outcomes of both procedures in the treatment of keratoconus. Therefore, we conducted a meta-analysis comparing postoperative outcome measures of penetrating keratoplasty versus deep anterior lamellar keratoplasty for keratoconus. MATERIALS AND METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews for eligible studies c...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
ConclusionNon-mechanical EXCIMER trephination seems to have advantages regarding postoperative corneal astigmatism and visual acuity compared with FEMTO trephination, especially in KC. A bigger sample size and longer follow-up are needed to evaluate the long-term impact of EXCIMER and FEMTO trephination on postoperative topographic and visual outcomes.
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
d T Abstract Penetrating keratoplasty in children is associated with very specific difficulties for the surgeon as well as for the patient and the parents. Special features are specific pediatric indications, which do not occur in adults, a more difficult examination and treatment adherence depending on the parents. Diseases with a favorable prognosis include keratoconus and herpetic keratitis. Especially sclerocornea and the Peters' anomaly often have a limited prognosis regarding vision and graft survival due to secondary malformations of the eye. In addition, younger age represents a risk fa...
Source: Der Ophthalmologe - Category: Opthalmology Authors: Tags: Ophthalmologe Source Type: research
CONCLUSION: Because of the undisputed clinical advantages, especially in eyes with advanced keratoconus, excimer laser trephination with orientation cogs/notches is currently favored in the routine daily practice in Homburg/Saar. PMID: 31696253 [PubMed - as supplied by publisher]
Source: Der Ophthalmologe - Category: Opthalmology Authors: Tags: Ophthalmologe Source Type: research
Members of the ASCRS Cornea Clinical Committee performed a review of the current literature on the corneal crosslinking (CXL) procedure for treating corneal ectasia. The members explored the data on the techniques currently in use and under investigation, including their advantages, safety profiles, risks, and cost analyses, compared with data on corneal transplantation. They concluded that CXL limits the progression of keratoconus, thus reducing the need for transplantation. They also found that compared with permitting the disease to progress naturally, CXL techniques carry significant and long-term cost and safety benef...
Source: Journal of Cataract and Refractive Surgery - Category: Opthalmology Authors: Tags: Review/Update Source Type: research
We present a series of three patients with previously undetected corneal pathology in grafted corneal tissue following keratoplasty for keratoconus. Postoperatively, a faint layer of anterior stromal haze involving the graft was observed in each patient upon slit lamp examination. Anterior segment optical coherence tomography (AS-OCT) confirmed the presence of anterior stromal scarring across the transplanted cornea. However, the ocular and systemic medical histories of the donors were unremarkable. As the suboptimal donor corneal tissue may escape the standard screening protocols, eye banks should consider adding AS-OCT i...
Source: Indian Journal of Ophthalmology - Category: Opthalmology Authors: Source Type: research
Conclusions: Improved topographic and biomechanic indexes at 1 year after CXL suggest it‘s potential as first-line therapy for RKC, as it is for KC.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Conclusions: With long-term follow-up, late post-PK ectasia becomes an increasing problem. PALK can be a successful surgical option to reinforce the ectatic area while preserving a functional clear PK. By adding donor corneal tissue, PALK restores the ectatic area, improves visual acuity, keratometric values, and astigmatism, and preserves the functional graft while avoiding the higher risks of a larger diameter PK.
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research
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