Corneal transplants for the treatment of congenital corneal opacities.

PURPOSE: To describe the results of corneal transplants in infants and young children with congenital corneal disorders.

METHODS: The charts of 38 children who underwent corneal transplantation for congenital corneal opacities from 1988 to 1999 at the Hospital for Sick Children, Toronto, Ontario, were reviewed. Parameters reviewed included indication, age at diagnosis and surgery, graft size, graft clarity, repeat surgery, glaucoma pre- and postsurgery, visual acuity, and refraction.

RESULTS: Thirty-eight children (63 eyes) underwent 86 corneal transplants. The four most common indications for surgery included posterior polymorphous dystrophy, Peters anomaly, congenital glaucoma, and sclerocornea. Mean follow-up was 40.4 +/- 30.2 months (range, 2-111 months). Seventy-eight percent of the grafts were clear at the final follow-up visit. There were 23 repeat grafts in the entire group.

CONCLUSIONS: The overall success rate of graft clarity was 78% for children undergoing corneal transplantation for congenitally opaque corneas. Best results were achieved in patients with posterior polymorphous dystrophy, followed by patients with Peters anomaly. Sclerocornea and congenital glaucoma carried a 50% chance of success, with repeated transplants needed for many of the eyes.