1. Long-Term Outcome of Corneal Transplant Surgery in Pediatric Patients with Keratoconus Anna Djougarian, MD Hofstra / North Shore-LIJ Medical Center Gerald Zaidman, MD Westchester Medical Center

2. Financial Disclosure The authors have no financial interests to disclose.

3. Purpose To investigate the outcome of corneal transplant surgery (CTS) in children with keratoconus (KCN).

4. Methods Four years ago a retrospective chart review was conducted of all children under 18 years of age that had CTS for KCN from 2000-2008. This is a follow-up study and updated chart review of these patients. We are also presenting data on some new children who have had CTS for KCN since our last review.

5. Results 31 eyes of 24 children had CTS. Mean age was 15.9 years, ranging from 11 to 18. 21(68%) had bilateral disease. 6 (19%) eyes had hydrops. Mean K at presentation was 55.2. Mean follow-up was 2.3 years, ranging from 0.02 years to 12.5 years.

6. Results 30/31 eyes had clear grafts. 14/31 eyes had rejection episodes; 13 cleared. 1 eye had controlled glaucoma. No eyes had cataracts.

7. Results BCVA Post-CTS o 13/31 eyes ≥20/25 o 28/31 eyes ≥20/40 o Of the remaining 3 eyes with BCVA <20/40 2 eyes (20/60 and CF) were lost to follow-up less than 2 months following CTS 1 (20/100) blunt trauma BCVA Pre-CTS o 6 eyes 20/30-20/50 o 6 eyes 20/60-20/100 o 9 eyes 20/150-20/400 o 10 eyes ≤CF (of which, 6 eyes had hydrops)

8. Conclusion 90% of pediatric patients with keratoconus did well following corneal transplant surgery with excellent visual recovery and few complications. There was a 45.2% incidence of graft rejection but nearly all cleared with medical therapy.