Keratoplasty in congenital corneal opacity
Alex Joseph, S Tony Fernandez, TP Ittyerah, John Williams
Department of Ophthalmology, Little Flower Hospital, Angamally, Kerala, India
Little Flower Hospital, Angamally, Kerala
|How to cite this article:|
Joseph A, Fernandez S T, Ittyerah T P, Williams J. Keratoplasty in congenital corneal opacity. Indian J Ophthalmol 1980;28:79-80
|How to cite this URL:|
Joseph A, Fernandez S T, Ittyerah T P, Williams J. Keratoplasty in congenital corneal opacity. Indian J Ophthalmol [serial online] 1980 [cited 2013 Dec 6];28:79-80. Available from: 
Congenital corneal opacity is not an uncommon occurrence and a considerable number of cases have been published in the literature. The disturbance may be limited to the cornea itself, where it may be a small localised lesion or may involve the entire cornea, or may be associated with other abnormalities of the eye ball. The literature regarding the aetiology of these changes is divided between two schools of thought, the theory of arrested development and that of intrauterine inflammation. The management is controversial.
| Case report|| |
A two month old male child was brought to the outpatient clinic of our hospital with congenital corneal opacity. Examination under anaesthesia showed bilateral total corneal opacity. Intra ocular tension was 14.6 mm of Hg in both eyes. Corneal diameter was 9 mm. Details of the other parts were not clear due to the opaque cornea. Child was free from other congenital abnormalities. A penetrating keratoplasty was done in the right eye under general anaesthesia when the child was three months old. 6.5 mm trephine was used and the graft was held in position with 16 interrupted sutures using 6 `0' virgin silk. A central tarsorrhaphy was done at the end of the procedure. Daily dressing was done with framycetin and gentamicin eye drops. The tarsorrhaphy was released after two weeks and subconjunctival Dexamethasone was given. The child was discharged after two weeks and was advised gentamicin and dexamethasone drops thrice a day and framycetin eye drops at bed time. Examination under anaesthesia was done once in two weeks for a period of three months. Now the child is 11 months old and the graft is still clear.
| Discussion|| |
Even though the treatment of choice in bilateral congenital total corneal opacity is keratoplasty, there is a wide spread reluctance to perform this surgery in children. If a congenital corneal opacity is left untreated, the eye becomes amblyopic and useful vision may not be regained if keratoplasty is performed after a lapse of some years. This occurrence of amblyopia is overlooked due to the surgeon's hesitancy in operating on children. The option about the age in Keratoplasty is varied. Leigh recommends 16 years, Paton 14 years and Jayle 11 years as the minimum age required for keratoplasty. Gnanadoss reported successful results in a child of 22 years. The youngest patient on record is a 11 month old baby. The purpose of this communication is to share our experience of a successful penetrating keratoplasty in an infant, 3 months old, who was born with bilateral total corneal opacity.