Oftalmologia Pediátrica, Serviço de Oftalmologia, Centro Hospitalar de Lisboa Central
Apresentado como poster no 6th Congress of EuCornea. Barcelona, Setembro 2015
Purpose: To explore the indications, efficacy, and complications of anterior surface reconstruction in pediatric age, with the technique of anterior lamellar keratoplasty in conjunction with amniotic membrane grafting.
Setting/venue: Cornea Department, Centro Hospitalar de Lisboa Central.
Methods: Retrospective case study analysis of 3 patients (3 eyes) was performed, 2 males (6 and 8 years old) and 1 female (2 years old): 2 patients with chemical burns and 1 patient with the diagnosis of a large anterior surface dermoid cyst and dermolipoma. Anterior lamellar grafts were obtained through microkeratome cuts from DSAEK preparation. Conjunctivoplasty with lysis of symblephara and excertion of choristomata where respectively performed, followed by lunar lamellar keratoplasty, suture with 10-0 monofilament and amniotic membrane grafting. Postoperative visual acuity (VA), corneal clarity, astigmatism, and complications were studied during a follow-up of 6 to 12 months.
Results: No recurrences of symblephara or choristomata were observed and visual acuity was more than 20/30. After removing the sutures, the astigmatism did not exceed 3 diopters in the older patients. No postoperative complications were observed.
Conclusions: The combination of corneal grafting and amniotic membrane transplantation was found to be an excellent synergistic method for ocular surface rehabilitation, with great cosmetic outcome. Furthermore, the well-matched graft configuration can reduce postoperative astigmatism and help restore or improve vision.