Pediatric penetrating keratoplasty and graft rejection: experience at the Hospital Infantil de México Federico Gómez.

Autor:	Velásquez-Monzón K; Department of Transplant Surgery, Hospital Infantil de México Federico Gómez, Mexico City, Mexico., Navarro-Peña MC; Department of Pediatric Ophthalmology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico., Klunder-Klunder M; Deputy Direction of Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico., Tsatsos M; Royal Eye Infirmary, Dorset County Hospital NHS Foundation Trust, Dorchester, United Kingdom., Ramírez-Ortiz MA; Department of Pediatric Ophthalmology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.; Aristotelian University of Thessaloniki, Greece.
Jazyk:	angličtina
Zdroj:	Boletin medico del Hospital Infantil de Mexico [Bol Med Hosp Infant Mex] 2020; Vol. 77 (1), pp. 23-27.
DOI:	10.24875/BMHIM.19000070
Abstrakt:	Background: Penetrating keratoplasty (PK) is a challenging surgical ocular procedure indicated for some pediatric patients with vision-threatening corneal disease damage. Pediatric PK is reserved for cases with advanced pathology or dysfunction as rejection and failure rates greatly supersede the rates of adult PK. The objective was to identify factors associated with graft rejection and failure amongst Mexican children undergoing primary PK for different indications. Methods: A retrospective review of consecutive pediatric PK medical records was conducted between 2001 and 2015 at the Hospital Infantil de México Federico Gómez. Graft survival was calculated using the Kaplan-Meier survival method. Results: During the 15 years of study, 67 eyes of 57 patients underwent PK. The mean age at the time of surgery was 11 years. The mean follow-up duration was 44 months. Keratoconus was the most common indication for PK (61%) followed by herpetic keratitis (15%) and other corneal dystrophies (10%). Mean graft survival time was 45.6 months (95% confidence interval 31.8-58.4 months, standard deviation = 0.069), with a survival rate of 70% at 1 year. Univariate Cox proportional hazard showed that being < 9 years of age at the time of the surgery (p = 0.023) and corneal dystrophies (p = 0.04) were prognostic factors for corneal rejection. Five eyes of five patients developed graft failure. Conclusions: Pediatric PK patients commonly experience graft rejection, which need to be promptly diagnosed and treated to minimize permanent damage. The age at the time of surgery and congenital corneal opacities is factors associated with a higher risk of rejection and failure. (Copyright: © 2019 Permanyer.)
Databáze:	MEDLINE
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