Pediatric penetrating keratoplasty and its unique challenges

Pediatric penetrating keratoplasty (PK) or full-thickness cornea transplant is defined as PK in a patient younger than 16 years old. This procedure is different from the adult due to anatomical differences of the globe, excessive inflammation postoperatively, the higher expectation of the parents, and less visual outcome due to amblyopia. It is often convenient to look at these issues at various stages such as preoperative, intraoperative, and postoperative phases. All these phases pose their own unique challenges that can be managed with various strategies. Proper indication of the PK, proper evaluation, timing of the surgery, surgical planning and technique, intraoperative considerations, postoperative management, follow-ups, and outcome measurement matters a lot for the success of this surgery. Everything eventually affects the outcome and prognosis of PK in the pediatric age group.