A 15-year experience with keratoplasty in the management of paediatric corneal diseases: indications and clinical outcomes in Malaysia.

Q3 Medicine

Medical Journal of Malaysia Pub Date : 2025-03-01

Y Z Wai, R Alias, N A Bahari, T Umapathy, S I Hosnaliza, J Rahmat

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引用次数: 0

Abstract

Introduction: Corneal blindness is a leading yet preventable cause of childhood blindness worldwide. Despite the need for corneal transplantation in paediatric cases, comprehensive data on its aetiology, clinical outcomes, and graft survival in Malaysia remain scarce. This study reviews the indications and outcomes of paediatric keratoplasty at Hospital Kuala Lumpur over the past 15 years.

Materials and methods: We conducted a retrospective evaluation of paediatric patients (less than 12-years-old) who underwent keratoplasty in Hospital Kuala Lumpur, from January 2008 to December 2022. We analysed demographic data, preoperative diagnoses, types of keratoplasty performed, and the 1-year graft survival rate.

Results: 100 eyes from 95 patients were included in the study, with a mean age of 4.39 ±3.32 years. The indications for keratoplasty included limbal dermoid (45%), anterior segment dysgenesis/Peter's anomaly (22%), infective keratitis (14%), congenital glaucoma (4%), and other pathologies (15%). 31/100 (31%) had corneal perforation. Of the patients, 56% underwent lamellar keratoplasty (LK), while 44% underwent penetrating keratoplasty (PK). Complications included wound dehiscence (4%) and graft melting (3%). 77% completed 1-year follow-up, and the overall 1-year graft survival rate was 54.5%. Limbal dermoid showed a better graft survival rate (72.2%) compared to other pathologies (39%), with a p-value of 0.004. LK has a higher 1-year graft survival rate of 66% compared to PK (36.7%) with a p-value of 0.003. Among the cases of perforated corneas, an overall 1-year graft survival rate of 25.8% (8/31) was observed, which was significantly lower compared to eyes without corneal perforation 73.9% (34/46) with a p-value of 0.008.

Conclusions: Limbal dermoid was the most common indication for paediatric keratoplasty, and it exhibited a better graft survival rate compared to other pathologies. A one-year graft survival rate varies among different indications of keratoplasty. Perforated cornea has a lower graft survival rate compared to non-perforated corneal pathology.

本刊更多论文

15年角膜移植治疗小儿角膜疾病的经验：马来西亚的适应症和临床结果

角膜失明是全球儿童失明的主要原因，但可预防。尽管在儿童病例中需要角膜移植，但马来西亚关于其病因、临床结果和移植物存活率的综合数据仍然很少。本研究回顾了过去15年来吉隆坡医院的儿童角膜移植手术的适应症和结果。材料和方法：我们对2008年1月至2022年12月期间在吉隆坡医院接受角膜移植术的儿童患者（小于12岁）进行了回顾性评估。我们分析了人口统计学数据、术前诊断、角膜移植手术类型和1年移植存活率。结果：95例患者100只眼纳入研究，平均年龄4.39±3.32岁。角膜移植术的适应症包括角膜缘皮样样（45%）、前段发育不良/彼得氏异常（22%）、感染性角膜炎（14%）、先天性青光眼（4%）和其他病理（15%）。31/100（31%）有角膜穿孔。56%的患者行板层角膜移植术（LK）， 44%行穿透性角膜移植术（PK）。并发症包括伤口裂开（4%）和移植物融化（3%）。77%的患者完成了1年随访，总体1年移植物生存率为54.5%。缘片状移植成活率为72.2%，高于其他病变（39%），p值为0.004。PK的1年存活率为36.7%，PK的1年存活率为66%，p值为0.003。角膜穿孔组1年总移植成活率为25.8%(8/31)，明显低于无角膜穿孔组73.9% (34/46)，p值为0.008。结论：角膜缘真皮样是儿童角膜移植最常见的指征，与其他病变相比，它具有更好的移植成活率。一年的移植存活率因角膜移植的不同适应症而异。与非穿孔角膜病理相比，穿孔角膜移植存活率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Journal of Malaysia Medicine-Medicine (all)

CiteScore

1.20

自引率

0.00%

发文量

165

期刊介绍： Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.