Indications and Techniques of Pediatric Keratoplasty in Iran between 2006 and 2019
Seyed mohamadmehdi Moshtaghion1 , Mohammad Abolhosseini1 , Mozhgan Rezaei Kanavi2 *, Bahar kheiri1
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences
Abstract: To assess the indications and surgical techniques of pediatric keratoplasty in Iran over the past 14 years.
Methods: In a retrospective study, all the eye bank records of pediatric patients (< 18 years of age) who had undergone keratoplasty between April 2006 and March 2019 were reviewed and analyzed in terms of indications for keratoplasty, surgical techniques, and their corresponding trends over the 14-year period.
Results: Our database included 2148 eye bank records of 1886 pediatric cases with a mean of 11.2 ± 4.5 years at the time of surgery who had undergone pediatric keratoplasty between 2006 and 2019. The leading indications for pediatric keratoplasty, in order of decreasing frequency, were keratoconus (KCN, n = 931, 43.36%), followed by corneal scars and opacities (CSO, n = 345, 16.06%), corneal degenerations and dystrophies (CDs, n = 253, 11.78%), regrafts (n = 157, 07.31%), active keratitis (AK, n = 153, 07.12%), and bullous keratopathies (BK, n = 117, 05.44%). Among all the indications for pediatric keratoplasty, excepting regraft (P = 0.042), no significant change of trend was noted in other indications for keratoplasty. In the subgroup analyses of two segregated age groups, the leading indications for keratoplasty were different between the groups. KCN was the most common indication for corneal transplant in the age group > 12 years (64.6%); however, it was the second leading indication for keratoplasty (22.5%) after CSO (23,2%) in the youngest age group (< 12 years). The rates of CDs and AK in the youngest age group were significantly more than the oldest age group (both P < 0.001).
Conclusion: Keratoconus was the leading indication for pediatric corneal keratoplasty in Iran.
Although PKP was the predominant keratoplasty procedure for the treatment of pediatric corneal disorders, the adoption of DSAEK showed a significantly increasing trend during the past 14 years.
