Poor graft survival in children younger than 5, whereas grafts in teens show good survival
THURSDAY, March 3 (HealthDay News) -- Corneal graft survival in patients younger than 20 varies more by indication than by the recipient's age, according to research published in the March issue of Ophthalmology.
Marie T. Lowe, from Flinders University in Bedford Park, Australia, and colleagues assessed the factors that affect penetrating corneal graft survival and visual outcomes in patients younger than 20 years. The researchers identified records from 640 patients, with 765 penetrating corneal grafts who were followed up from 1985 to 2009. Snellen acuity at defined intervals post-graft and at the most recent follow-up, and the probability of graft survival were the main outcomes of the study.
The investigators found that, compared to children aged 5 to 12 years, children younger than 5 years showed poor graft survival. Teens aged 13 to 16 years had better graft survival than other age groups, with 86 percent of grafts in that age for keratoconus. Fourteen percent of pediatric grafts failed; the majority of these (65 percent) were within two years. The reason for graft failure was either unknown or due to irreversible rejection in 44 percent of cases. Graft survival was significantly associated with indication for graft, history of intraocular surgery, vascularization, graft inflammation, refractive surgery, and post-graft operative procedures.
"Penetrating corneal transplants in infants exhibit relatively poor survival and visual outcomes," the authors write. "In contrast, corneal grafts in adolescents aged 13 to 19 years were mostly performed for keratoconus, and graft survival and visual outcomes were excellent."
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