Oversized grafts in children
Section snippets
Materials and methods
Forty consecutive patients, 12 years of age and younger, with bilateral or unilateral corneal opacity were enrolled for the study from the Cornea Service of our center. The inclusion factor was the presence of a corneal opacity with a shallow anterior chamber or corneoiridic scars.
Exclusion criteria included uncontrolled glaucoma, posterior segment pathology, and active corneal infection. Initial examination included a detailed record of the history, visual acuity testing, slit-lamp
Results
Of the 40 children enrolled in our study, 28 were males and 12 were females with an age range of 6 months to 12 years (Table 1). The mean age was 4.4 ± 4 years in the congenital opacity group and 6.3 ± 2.2 years in the acquired corneal scarring group. The major causes of corneal opacification were corneal ulceration (25%), trauma (20%), and sclerocornea (20%) (Table 2). Preoperative visual acuity was less than 20/200 in all cases. All eyes in the congenital group were phakic, while one eye in
Discussion
Corneal grafting in children has traditionally included the use of a 0.5-mm oversized donor corneal button, which was punched from the endothelial side. Despite optimal suturing, many of the pediatric patients developed shallow anterior chambers and anterior synechiae during the postoperative period. Corneoiridic scars and corneal opacification due to mesodermal dysgenesis were the major indications for surgery in such cases. Most of these cases had a shallow anterior chamber before surgery.
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