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Mohamadmehdi Moshtaghion S, Abolhosseini M, Kheiri B, Ali Javadi M, Ziaee Ardakani L, Rezaei Kanavi M. Eye Bank Records on Pediatric Keratoplasty. JOVR [Internet]. 2022Aug.9 [cited 2024Jul.17];17(3):324–337. Available from: https://knepublishing.com/index.php/JOVR/article/view/11569
https://doi.org/10.18502/jovr.v17i3.11569
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authors
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Seyed Mohamadmehdi Moshtaghion
Seyed Mohamadmehdi Moshtaghion
Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mohammad Abolhosseini
Mohammad Abolhosseini
Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bahareh Kheiri
Bahareh Kheiri
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mohammad Ali Javadi
Mohammad Ali Javadi
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Leila Ziaee Ardakani
Leila Ziaee Ardakani
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mozhgan Rezaei Kanavi
Mozhgan Rezaei Kanavi
Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Published Date
- Aug 9, 2022
Eye Bank Records on Pediatric Keratoplasty
Abstract
Purpose: To report eye bank records for pediatric keratoplasty in Iran between 2006 and 2019.
Methods: In a retrospective study, all electronic records of the Central Eye Bank of Iran for pediatric keratoplasty between April 2006 and March 2019 were analyzed in terms of indications for keratoplasty, surgical techniques, their corresponding trends, and post-transplantation graft clarity.
Results: Our database included 2178 eyes from 2050 pediatric cases. The leading indications for keratoplasty included acquired nontraumatic diseases (75.8%), congenital abnormalities (12.7%), corneal regraft (8.3%), and acquired traumatic diseases (3.2%). Keratoconus was the most common acquired nontraumatic cause (58%) and more common in the age group >12 years than those ≤12 years (P < 0.001). Congenital corneal abnormalities and regrafts were more common in the age group ≤12 years (both Ps < 0.001). The most common surgical technique was penetrating keratoplasty (PKP, 90.9%) followed by deep anterior lamellar keratoplasty (DALK, 7.3%), Descemet stripping automated endothelial keratoplasty (DSAEK, 1.1%), anterior lamellar keratoplasty (0.5%), and keratolimbal allograft transplantation (0.2%). DSAEK was more common in the age group ≤12 years (P = 0.002), which, unlike PKP and DALK, showed a significant ascending trend over the 14-year period (P = 0.018). Posttransplantation graft clarity was 96.8%.
Conclusion: Keratoconus was the leading indication for pediatric keratoplasty in Iran. Although PKP was the predominant keratoplasty procedure for the treatment of pediatric corneal disorders, it showed a significant descending trend over the 14 years.
Keywords:
Deep Anterior Lamellar Keratoplasty, Descemet Membrane Stripping Automated Endothelial Keratoplasty, Keratoconus, Pediatric Keratoplasty, Penetrating Keratoplasty
References
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12. Zhao S, Le Q, Yao W, Xu J. Indications and techniques of pediatric keratoplasty in Eastern China from 2008 to 2017. Cornea 2019;38:1370–1376.
13. Stulting RD, Sumers KD, Cavanagh HD, Waring GO 3rd, Gammon JA. Penetrating keratoplasty in children. Ophthalmology 1984;91:1222–1230.
14. Patel HY, Ormonde S, Brookes NH, Moffatt LS, McGhee CN. The indications and outcome of paediatric corneal transplantation in New Zealand: 1991–2003. Br J Ophthalmol 2005;89:404–408.
15. McClellan K, Lai T, Grigg J, Billson F. Penetrating keratoplasty in children: Visual and graft outcome. Br J Ophthalmol 2003;87:1212–1214.
16. Buzzonetti L, Ardia R, Petroni S, Petrocelli G, Valente P, Parrilla R, et al. Four years of corneal keratoplasty in Italian paediatric patients: Indications and clinical outcomes. Graefes Arch Clin Exp Ophthalmol 2016;254:2239–2245.
17. Mun-Wei L, Md Said H, Punitan R, Ibrahim M, Shatriah I. Indications, clinical outcomes, and survival rate of pediatric penetrating keratoplasty in suburban Malaysia: A 10-year experience. Cureus 2018;10:e3744.
18. Huang C, O’Hara M, Mannis MJ. Primary pediatric keratoplasty: Indications and outcomes. Cornea 2009;28:1003–1008.
19. Low JR, Anshu A, Tan AC, Htoon HM, Tan DT. The outcomes of primary pediatric keratoplasty in Singapore. Am J Ophthalmol 2014;158:496–502.
20. Al-Ghamdi A, Al-Rajhi A, Wagoner MD. Primary pediatric keratoplasty: Indications, graft survival, and visual outcome. J AAPOS 2007;11:41–47.
21. Di Zazzo A, Bonini S, Crugliano S, Fortunato M. The challenging management of pediatric corneal transplantation: An overview of surgical and clinical experiences. Jpn J Ophthalmol 2017;61:207–217.
22. Xavier Dos Santos Araújo ME, Santos NC, Souza LB, Sato EH, de Freitas D. Primary pediatric keratoplasty: Etiology, graft survival, and visual outcome. Am J Ophthalmol 2020;212:162–168.
23. Kusumesh R, Vanathi M. Graft rejection in pediatric penetrating keratoplasty: Clinical features and outcomes. Oman J Ophthalmol 2015;8:33–37.
24. Limaiem R, Chebil A, Baba A, Ben Youssef N, Mghaieth F, El Matri L. Pediatric penetrating keratoplasty: Indications and outcomes. Transplant Proc 2011;43:649–651.
25. Hong J. Xu J, Sheng M, Liu Y, Zhu L. Pediatric penetrating keratoplasty in Shanghai: A retrospective multiple centre study from 2003 to 2007. Chin Med J 2008;121:1911–1914.
26. Aasuri MK, Garg P, Gokhle N, Gupta S. Penetrating keratoplasty in children. Cornea 2000;19:140–144.
27. Zhu AY, Prescott CR. Recent surgical trends in pediatric corneal transplantation: A 13-year review. Cornea 2019;38:546–552.
28. Majander A, Kivelä TT, Krootila K. Indications and outcomes of keratoplasties in children during a 40-year period. Acta Ophthalmol 2016;94:618–624.
29. Hovlykke M, Hjortdal J, Ehlers N, Nielsen K. Clinical results of 40 years of paediatric keratoplasty in a single university eye clinic. Acta Ophthalmol 2014;92:370–377.
30. Kanavi MR, Javadi MA, Sanagoo M. Indications for penetrating keratoplasty in Iran. Cornea 2007;26:561–563.
31. Alldredge OC, Krachmer JH. Clinical types of corneal transplant rejection. Their manifestations, frequency, preoperative correlates, and treatment. Arch Ophthalmol 1981;99:599–604.
32. Javadi MA, Baradaran-Rafii AR, Zamani M, Karimian F, Zare M, Einollahi B, et al. Penetrating keratoplasty in young children with congenital hereditary endothelial dystrophy. Cornea 2003;22:420–423.
33. Sharma N, Agarwal R, Jhanji V, Bhaskar S, Kamalakkannan P, Nischal KK. Lamellar keratoplasty in children. Surv Ophthalmol 2020;65:675–690.
34. Madi S, Santorum P, Busin M. Descemet stripping automated endothelial keratoplasty in pediatric age group. Saudi J Ophthalmol 2012;26:309–313.
35. Foroutan AR, Gheibi GH, Joshaghani M, Ahadian A, Foroutan P. Traumatic wound dehiscence and lens extrusion after penetrating keratoplasty. Cornea 2009;28:1097–1099.
36. Zhu AY, Marquezan MC, Kraus CL, Prescott CR. Pediatric corneal transplants: Review of current practice patterns. Cornea 2018;37:973–980.
37. Yang F, Hong J, Xiao G, Feng Y, Peng R, Wang M, et al. Descemet stripping endothelial keratoplasty in pediatric patients with congenital hereditary endothelial dystrophy. Am J Ophthalmol 2020;209:132–140.
38. Keane M, Coster D, Ziaei M, Williams K. Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus. Cochrane Database Syst Rev 2014;2014:CD009700.
39. Henein C, Nanavaty MA. Systematic review comparing penetrating keratoplasty and deep anterior lamellar keratoplasty for management of keratoconus. Cont Lens Anterior Eye 2017;40:3–14.
40. Ali Javadi M, Kanavi MR, Safi S. A 27-year report from the central eye bank of Iran. J Ophthalmic Vis Res 2020;15:149–159.
41. Baradaran-Rafii A, Eslani M, Djalillian AR. Complications of keratolimbal allograft surgery. Cornea 2013;32:561–566.
42. Baradaran-Rafii A, Ebrahimi M, Kanavi MR, Taghi-Abadi E, Aghdami N, Eslani M, et al. Midterm outcomes of autologous cultivated limbal stem cell transplantation with or without penetrating keratoplasty. Cornea 2010;29:502– 509.
2. Park CY, Lee JK, Gore PK, Lim CY, Chuck RS. Keratoplasty in the United States: A 10-year review from 2005 through 2014. Ophthalmology 2015;122:2432–2442.
3. Droutsas K, Bagikos G, Miltsakakis D, Georgalas I, Lazaridis A, Chatzistefanou K, et al. Trends in indications and techniques of corneal transplantation from 1999 through 2015 at a tertiary referral center in Athens, Greece. J Ophthalmol 2018;2018:9132083.
4. Bozkurt TK, Acar B, Kilavuzoglu AE, Akdemir MO, Hamilton DR, Cosar Yurteri CB, et al. An 11-year review of keratoplasty in a tertiary referral center in Turkey: Changing surgical techniques for similar indications. Eye Contact Lens 2017;43:364–370.
5. Gulias-Cañizo R, Gonzalez-Salinas R, Hernandez-Zimbron LF, Hernandez-Quintela E, Sanchez-Huerta V. Indications and outcomes of pediatric keratoplasty in a tertiary eye care center: A retrospective review. Medicine 2017;96:e8587.
6. Ting DS, Sau CY, Srinivasan S, Ramaesh K, Mantry S, Roberts F. Changing trends in keratoplasty in the West of Scotland: a 10-year review. Br J Ophthalmol 2012;96:405–408.
7. Sharma N, Prakash G, Titiyal JS, Tandon R, Vajpayee RB. Pediatric keratoplasty in India: Indications and outcomes. Cornea 2007;26:810–813.
8. Shi W, Jin H, Li S, Liu M, Xie L. Indications of paediatric keratoplasty in north China. Clin Exp Ophthalmol 2007;35:724–727.
9. Dong PN, Han TN, Aldave AJ, Chau HT. Indications for and techniques of keratoplasty at Vietnam national institute of ophthalmology. Int J Ophthalmol 2016;9:379–383.
10. Mathews PM, Lindsley K, Aldave AJ, Akpek EK. Etiology of global corneal blindness and current practices of corneal transplantation: A focused review. Cornea 2018;37:1198–1203.
11. Lowe MT, Keane MC, Coster DJ, Williams KA. The outcome of corneal transplantation in infants, children, and adolescents. Ophthalmology 2011;118:492–497.
12. Zhao S, Le Q, Yao W, Xu J. Indications and techniques of pediatric keratoplasty in Eastern China from 2008 to 2017. Cornea 2019;38:1370–1376.
13. Stulting RD, Sumers KD, Cavanagh HD, Waring GO 3rd, Gammon JA. Penetrating keratoplasty in children. Ophthalmology 1984;91:1222–1230.
14. Patel HY, Ormonde S, Brookes NH, Moffatt LS, McGhee CN. The indications and outcome of paediatric corneal transplantation in New Zealand: 1991–2003. Br J Ophthalmol 2005;89:404–408.
15. McClellan K, Lai T, Grigg J, Billson F. Penetrating keratoplasty in children: Visual and graft outcome. Br J Ophthalmol 2003;87:1212–1214.
16. Buzzonetti L, Ardia R, Petroni S, Petrocelli G, Valente P, Parrilla R, et al. Four years of corneal keratoplasty in Italian paediatric patients: Indications and clinical outcomes. Graefes Arch Clin Exp Ophthalmol 2016;254:2239–2245.
17. Mun-Wei L, Md Said H, Punitan R, Ibrahim M, Shatriah I. Indications, clinical outcomes, and survival rate of pediatric penetrating keratoplasty in suburban Malaysia: A 10-year experience. Cureus 2018;10:e3744.
18. Huang C, O’Hara M, Mannis MJ. Primary pediatric keratoplasty: Indications and outcomes. Cornea 2009;28:1003–1008.
19. Low JR, Anshu A, Tan AC, Htoon HM, Tan DT. The outcomes of primary pediatric keratoplasty in Singapore. Am J Ophthalmol 2014;158:496–502.
20. Al-Ghamdi A, Al-Rajhi A, Wagoner MD. Primary pediatric keratoplasty: Indications, graft survival, and visual outcome. J AAPOS 2007;11:41–47.
21. Di Zazzo A, Bonini S, Crugliano S, Fortunato M. The challenging management of pediatric corneal transplantation: An overview of surgical and clinical experiences. Jpn J Ophthalmol 2017;61:207–217.
22. Xavier Dos Santos Araújo ME, Santos NC, Souza LB, Sato EH, de Freitas D. Primary pediatric keratoplasty: Etiology, graft survival, and visual outcome. Am J Ophthalmol 2020;212:162–168.
23. Kusumesh R, Vanathi M. Graft rejection in pediatric penetrating keratoplasty: Clinical features and outcomes. Oman J Ophthalmol 2015;8:33–37.
24. Limaiem R, Chebil A, Baba A, Ben Youssef N, Mghaieth F, El Matri L. Pediatric penetrating keratoplasty: Indications and outcomes. Transplant Proc 2011;43:649–651.
25. Hong J. Xu J, Sheng M, Liu Y, Zhu L. Pediatric penetrating keratoplasty in Shanghai: A retrospective multiple centre study from 2003 to 2007. Chin Med J 2008;121:1911–1914.
26. Aasuri MK, Garg P, Gokhle N, Gupta S. Penetrating keratoplasty in children. Cornea 2000;19:140–144.
27. Zhu AY, Prescott CR. Recent surgical trends in pediatric corneal transplantation: A 13-year review. Cornea 2019;38:546–552.
28. Majander A, Kivelä TT, Krootila K. Indications and outcomes of keratoplasties in children during a 40-year period. Acta Ophthalmol 2016;94:618–624.
29. Hovlykke M, Hjortdal J, Ehlers N, Nielsen K. Clinical results of 40 years of paediatric keratoplasty in a single university eye clinic. Acta Ophthalmol 2014;92:370–377.
30. Kanavi MR, Javadi MA, Sanagoo M. Indications for penetrating keratoplasty in Iran. Cornea 2007;26:561–563.
31. Alldredge OC, Krachmer JH. Clinical types of corneal transplant rejection. Their manifestations, frequency, preoperative correlates, and treatment. Arch Ophthalmol 1981;99:599–604.
32. Javadi MA, Baradaran-Rafii AR, Zamani M, Karimian F, Zare M, Einollahi B, et al. Penetrating keratoplasty in young children with congenital hereditary endothelial dystrophy. Cornea 2003;22:420–423.
33. Sharma N, Agarwal R, Jhanji V, Bhaskar S, Kamalakkannan P, Nischal KK. Lamellar keratoplasty in children. Surv Ophthalmol 2020;65:675–690.
34. Madi S, Santorum P, Busin M. Descemet stripping automated endothelial keratoplasty in pediatric age group. Saudi J Ophthalmol 2012;26:309–313.
35. Foroutan AR, Gheibi GH, Joshaghani M, Ahadian A, Foroutan P. Traumatic wound dehiscence and lens extrusion after penetrating keratoplasty. Cornea 2009;28:1097–1099.
36. Zhu AY, Marquezan MC, Kraus CL, Prescott CR. Pediatric corneal transplants: Review of current practice patterns. Cornea 2018;37:973–980.
37. Yang F, Hong J, Xiao G, Feng Y, Peng R, Wang M, et al. Descemet stripping endothelial keratoplasty in pediatric patients with congenital hereditary endothelial dystrophy. Am J Ophthalmol 2020;209:132–140.
38. Keane M, Coster D, Ziaei M, Williams K. Deep anterior lamellar keratoplasty versus penetrating keratoplasty for treating keratoconus. Cochrane Database Syst Rev 2014;2014:CD009700.
39. Henein C, Nanavaty MA. Systematic review comparing penetrating keratoplasty and deep anterior lamellar keratoplasty for management of keratoconus. Cont Lens Anterior Eye 2017;40:3–14.
40. Ali Javadi M, Kanavi MR, Safi S. A 27-year report from the central eye bank of Iran. J Ophthalmic Vis Res 2020;15:149–159.
41. Baradaran-Rafii A, Eslani M, Djalillian AR. Complications of keratolimbal allograft surgery. Cornea 2013;32:561–566.
42. Baradaran-Rafii A, Ebrahimi M, Kanavi MR, Taghi-Abadi E, Aghdami N, Eslani M, et al. Midterm outcomes of autologous cultivated limbal stem cell transplantation with or without penetrating keratoplasty. Cornea 2010;29:502– 509.