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Infants with significant corneal opacities are at risk for development of profound deprivation amblyopia without surgical intervention. Early corneal transplantation is recommended. However, penetrating keratoplasty (PK) in young children is considered a high-risk procedure. Additionally, a poorer prognosis has been described in children with congenital corneal opacities when compared with acquired corneal opacities.1,2 Allograft rejection is the cause in the great majority of pediatric graft failures.
Implantation of a keratoprosthesis, or a synthetic cornea, is considered for patients who are at high risk for donor corneal transplantations. Although significant early and late postoperative complications can occur, favorable results have been achieved in patients with a relatively healthy ocular surface, such as in cases with multiple immunologic graft failures.3
Botelho PJ, Congdon NG, Handa JT, Akpek EK. Keratoprosthesis in High-Risk Pediatric Corneal Transplantation: First 2 Cases. Arch Ophthalmol. 2006;124(9):1356–1357. doi:10.1001/archopht.124.9.1356
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