Japanese Journal of Ophthalmology

, Volume 61, Issue 3, pp 207–217 | Cite as

The challenging management of pediatric corneal transplantation: an overview of surgical and clinical experiences

  • Antonio Di Zazzo
  • Stefano Bonini
  • Salvatore Crugliano
  • Michele Fortunato
Review
First Online:
Received:
Accepted:
  • 235 Downloads

Abstract

Purpose

Pediatric keratoplasty is an immense challenge because of the technical complexity of the procedure and the high risk of rejection in young graft recipients. Our aim is to describe the major indications and appropriate timing of corneal transplantation intervention, including a report of our experience and surgical tips, in conjunction with the current literature.

Methods

Review of the literature on indications for keratoplasty in pediatric patients classified as: congenital, traumatic and acquired non-traumatic opacities. We additionally explored the challenges corneal surgeons face in performing this type of surgery and review the most pressing transplant-related problems and their management.

Results

Outcomes after pediatric keratoplasty, in terms of visual development, restoration and clarity of the graft, are influenced by peri-operative local and systemic conditions and factors, and by intraoperative management of the transplantation procedure itself.

Conclusion

Pediatric corneal transplantation is a critical tool for visual restoration and development in young patients with corneal opacities, particularly during the critical period of visual development. Successful management of the significant challenges associated with pediatric keratoplasty requires customized clinical and surgical management of each patient with particular attention paid to proper post-operative rehabilitation.

Keywords

Corneal transplantation Pediatric Congenital disease Peter’s anomaly 
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Notes

Conflicts of interest

A. Di Zazzo, None; S. Bonini, None; S. Crugliano, None; M. Fortunato, None.

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Copyright information

© Japanese Ophthalmological Society 2017

Authors and Affiliations

  • Antonio Di Zazzo
    • 1
  • Stefano Bonini
    • 2
  • Salvatore Crugliano
    • 3
  • Michele Fortunato
    • 4
  1. 1.IRCCS G.B. Bietti Foundation ONLUSRomeItaly
  2. 2.Department of OphthalmologyUniversity Campus Bio-Medico of RomeRomeItaly
  3. 3.Humanitas GroupMater Domini HospitalCastellanzaItaly
  4. 4.IRCSS Bambino Gesù Pediatric HospitalRomeItaly

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