PDF(Pubmed)
Abstract：
Pediatric corneal transplant is a highly demanding and technically challenging procedure for the cornea surgeon in today\'s era. These cases pose unique challenges in clinical and surgical management. The indications of pediatric corneal transplant can be therapeutic, tectonic, optical, and cosmetic. Pediatric patients undergoing corneal transplants are at a high risk of graft infection, failure, rejection, dehiscence, and amblyopia due to young age, robust immune system, increased incidence of trauma, and compliance issues. The other factors contributing to graft failure can be allograft rejection, secondary glaucoma, corneal vascularization, multiple surgeries, vitreous prolapse, and lack of treatment compliance. A successful corneal transplant in children depends on meticulous preoperative evaluation, uneventful surgery, the expertise of a corneal surgeon, and regular and timely postoperative follow-up. Therapeutic and optical penetrating keratoplasty are the most commonly performed transplants in children. However, with the advancements in surgical technique and management protocol, the current focus has shifted toward lamellar keratoplasty. Lamellar keratoplasty offers early visual recovery and potentially fewer complications. Visual rehabilitation through corneal transplant in otherwise blind eyes can be a boon for the children. Recently, keratoprostheses have been promising in children with multiple graft failures. The current review gives insights into epidemiology, etiology, indications, clinical characteristics, investigations, management options, recent advances, and the future of pediatric corneal transplants. As surgical techniques continue to grow and comprehension of pediatric corneal transplants is improving, we can safeguard these eyes with the best possible anatomical and functional outcomes.
摘要：
在当今时代，小儿角膜移植对角膜外科医生来说是一项要求很高，技术上具有挑战性的手术。这些病例在临床和手术管理中提出了独特的挑战。小儿角膜移植的适应症可以是治疗性的，构造,光学，和化妆品。接受角膜移植的儿科患者有很高的移植物感染风险,失败,拒绝,开裂，和弱视由于年轻，强大的免疫系统，创伤发生率增加，和合规问题。导致移植物失败的其他因素可能是同种异体移植物排斥，继发性青光眼,角膜血管化,多次手术,玻璃体脱垂,缺乏治疗依从性。儿童角膜移植的成功取决于细致的术前评估，顺利的手术,角膜外科医生的专业知识，术后定期及时随访。治疗性和光学穿透性角膜移植术是儿童最常见的移植。然而,随着手术技术和管理方案的进步，目前的焦点已转向板层角膜移植术。板层角膜移植术提供早期视力恢复和潜在的较少并发症。通过角膜移植在其他失明的眼睛中进行视觉康复对儿童来说可能是一个福音。最近,角膜假体在多次移植失败的儿童中很有希望。当前的评论提供了对流行病学的见解，病因学,适应症,临床特征,调查,管理选项，最近的进步，以及小儿角膜移植的未来。随着手术技术的不断发展和对小儿角膜移植的理解正在提高，我们可以用最好的解剖和功能结果保护这些眼睛。
