Indications for pediatric keratoplasty in India

Purpose. To study the associations and indications for pediatric keratoplasty. Methods. We undertook a retrospective analysis of 415 grafts performed in 393 children, aged 12 years or younger between January 1993 and December 1997. The parameters evaluated were demographic data, socioeconomic status, preoperative diagnosis, and any systemic or ocular associations. Results, Of the 415 eyes operated on, 296 (71.32%) eyes underwent keratoplasty for acquired nontraumatic corneal opacities, 51 (12.28%) had congenital corneal conditions, 45 (10.85%) were regrafts, and 23 (5.54%) eyes had acquired traumatic corneal opacities. The cause of corneal opacification in the acquired nontraumatic group was infectious keratitis in 215 (72.63%) eyes and keratomalacia in 81 (27.36%) eyes. Systemic associations with the onset of the opacity in the acquired nontraumatic group were fever in 74 (25%) cases, diarrhea in 56 (18.9%) cases, and malnutrition in 98 (33.1%) cases. Seventeen (4.32%) children belonged to the lower middle class, 64 (16.28%) were in the upper lower class, and 312 (79.38%) were from the lower socioeconomic families based on the Kuppuswamy scale. Conclusions. Infectious keratitis is the major indication for pediatric keratoplasty in India. In the majority of the cases, the occurrence of corneal opacification is associated with poverty.