Our Summary

This research paper is about a study that looked at the effects of combining certain eye surgeries in children. These surgeries were a corneal transplant (replacing the clear front part of the eye), a glaucoma drainage device (a device to help drain fluid from the eye to treat glaucoma), and a pars plana vitrectomy (removing the gel-like substance in the center of the eye). These surgeries are often combined in adults, but it’s not well-known how well they work when combined in children.

The study looked at the medical records of children who had these surgeries at the Illinois Eye and Ear Infirmary between 2003 and 2017. The children were followed for an average of about 4 years after their surgery.

The results showed that about half of the children who had all three surgeries saw an improvement in their vision. The pressure inside their eyes also decreased on average. However, over half of all the children had complications from the surgeries.

The researchers concluded that combining these surgeries can be effective in treating complex eye diseases in children. However, because there’s a high risk of complications, doctors need to carefully consider whether a child should have these combined surgeries.

FAQs

  1. What are the three eye surgeries that were combined in the study?
  2. What were the results of the study on combining corneal transplant, glaucoma drainage device, and pars plana vitrectomy in children?
  3. What was the conclusion of the researchers about the combination of these surgeries in children?

Doctor’s Tip

A helpful tip a doctor might tell a patient about corneal transplant is to follow all post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include using prescribed eye drops, attending follow-up appointments, and avoiding activities that could put strain on the eyes. It’s also important to communicate any concerns or changes in vision to your doctor promptly.

Suitable For

Patients who are typically recommended for a corneal transplant are those with certain eye conditions that cannot be treated effectively with other methods. Some common reasons for a corneal transplant include:

  1. Keratoconus: a condition where the cornea becomes thin and cone-shaped, leading to distorted vision.
  2. Fuchs’ dystrophy: a condition where the inner layer of the cornea becomes swollen, leading to cloudy vision.
  3. Corneal scarring: caused by injury, infection, or other factors, leading to vision impairment.
  4. Corneal ulcers: severe infections on the cornea that do not respond to other treatments.
  5. Corneal degeneration: progressive thinning or weakening of the cornea, leading to vision loss.

In addition, patients who have undergone previous eye surgeries that were unsuccessful or have had trauma to the eye may also be recommended for a corneal transplant. It is important for patients to undergo a thorough evaluation by an ophthalmologist to determine if a corneal transplant is the best treatment option for their specific condition.

Timeline

Before a corneal transplant:

  • Patient undergoes a comprehensive eye exam to determine if a corneal transplant is necessary.
  • Patient may undergo other treatments or therapies to improve their eye condition before considering a transplant.
  • Patient is placed on a waiting list for a suitable donor cornea.
  • Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for surgery.

After a corneal transplant:

  • Patient undergoes the corneal transplant surgery, which typically takes about 1-2 hours.
  • Patient will be monitored closely in the immediate post-operative period to watch for any complications or signs of rejection.
  • Patient will need to use medicated eye drops to help prevent infection and rejection of the new cornea.
  • Patient will have regular follow-up appointments with their ophthalmologist to monitor the healing process and check for any signs of rejection.
  • Patient may need to wear an eye shield or glasses to protect the eye during the initial healing period.
  • Patient may experience fluctuations in vision as the eye heals and adjusts to the new cornea.
  • Patient may need to undergo additional surgeries or treatments to address any complications that arise after the transplant.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a corneal transplant in children?
  2. How will combining a corneal transplant with a glaucoma drainage device and pars plana vitrectomy affect the overall success of the surgeries?
  3. What is the expected recovery time and post-operative care for a child undergoing these combined surgeries?
  4. How will the child’s vision and quality of life be impacted by these surgeries in the long term?
  5. Are there any alternative treatment options that may be considered before opting for a corneal transplant in combination with other surgeries?
  6. What is the success rate of these combined surgeries in children compared to adults?
  7. How often will follow-up appointments be necessary to monitor the child’s progress and potential complications after the surgeries?
  8. Are there any lifestyle changes or restrictions that the child will need to follow after undergoing these surgeries?
  9. How experienced is the medical team in performing these combined surgeries in children, and what is their success rate?
  10. What are the expected costs associated with these surgeries, and will insurance cover them?

Reference

Authors: Bohm KJ, Fernandez-Vega A, Acaba-Berrocal L, Chan RVP, Cortina MS. Journal: Cornea. 2022 Dec 1;41(12):1530-1535. doi: 10.1097/ICO.0000000000002996. Epub 2022 Feb 4. PMID: 35120349