A recent study sought to determine the visual acuity and prognostic factors after successful penetrating keratoplasty (PK) in newborn to seven-year-old children with congenital corneal opacities. Researchers evaluated 60 eyes in 50 patients with clear grafts after PK for congenital corneal opacity and followed them for six to 82 months.

At the last follow-up, 71.7% of eyes achieved ambulatory vision (≥20/960), and 23.3% of eyes had visual acuities >20/260. A significantly higher proportion of bilateral opacity eyes (88.5%) achieved ambulatory vision compared with unilateral opacity eyes (58.8%). The study found no significant differences in visual acuity among the different follow-up subgroups (<12 months, 12 to 36 months and >36 months post-op). While there were no statistically significant differences between age and visual outcomes, the study’s results show a trend that the younger the age at surgery, the better the visual acuity.

Researchers believe the positive outcomes were achieved because the pathology in these cases was primarily corneal with no anterior chamber or iris involvement. They conclude that reducing astigmatism and reinforcing amblyopia treatment are possible measures for obtaining better visual outcomes after PK. Of all the surgical indications, unilateral sclerocorneal eyes showed the worst visual outcome.

Lin Q, Shi W, Miao S, et al. Visual outcomes and prognostic factors of successful penetrating keratoplasty in 0- to 7-year-old children with congenital corneal opacities. Cornea. 2018;37(10):1237-42.