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Purpose To evaluate the long-term corneal graft survival and risk factors for graft failure in pediatric eyes. Design Retrospective, interventional consecutive case series. Methods Unilateral eyes of 105 patients aged 16 years and below were included from the Singapore Corneal Transplant Study between April 4, 1991 and April 4, 2011. Corneal graft survival was calculated using Kaplan-Meier survival analysis, and survival distributions were compared using log-rank test. Results Mean recipient age was 8.38 ± 5.63 years (range 0.18–15.92 years). Mean follow-up time was 34.16 ± 39.10 months. Main diagnoses were corneal scar (22.9%), limbal dermoid (21.9%), anterior segment dysgenesis (15.2%), and keratoconus (14.3%). Forty-four eyes (41.9%) underwent penetrating keratoplasty (PK), 37 (35.2%) underwent anterior lamellar keratoplasty (ALK), 22 (21.0%) underwent lamellar corneal patch graft, and 2 (1.9%) underwent Descemet stripping automated endothelial keratoplasty (DSAEK). Kaplan-Meier survival rates for PK were 92.8% at 1 year, 88.9% at 2–4 years, and 80.9% at 5–16 years; survival rates for ALK were 88.0% at 1 year and 84.3% at 2–7 years; survival rates for corneal patch graft were 100% at 1–3 years and 90% at 4–10 years; these were not statistically significant ( P = .362). Deep corneal vascularization ( P = .012), preexisting active inflammation ( P = .023), preexisting glaucoma drainage device ( P = .023), and preexisting ocular surface disease ( P = .037) were associated with reduced graft survival in a univariate analysis. Conclusions We report good long-term graft survival following pediatric keratoplasty for various indications. Lamellar keratoplasty, when indicated, should be the procedure of choice in high-risk keratoplasties.

To describe 12-month changes in choroidal thickness after anti-vascular endothelial growth factor (anti-VEGF) therapy for typical age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV).Prospective, consecutive, noninterventional, longitudinal case series.This study included patients with typical AMD and PCV who received anti-VEGF therapy over a 12-month period. We used spectral-domain optical coherence tomography with enhanced depth imaging mode to measure choroidal thickness.Of the 163 patients, 77 had typical AMD and 86 had PCV. Patients with PCV were younger (67.6 vs 72.5 years, P.01) and received fewer anti-VEGF injections (3.9 vs 5.6, P = .02) than patients with typical AMD. Baseline subfoveal choroidal thickness was not significantly different between PCV and typical AMD eyes, and was thicker in the study eye compared to fellow eye in the typical AMD group (223.1 vs 208.8 μm, P.01). Subfoveal choroidal thickness decreased significantly in both typical AMD (213.7 μm to 190.3 μm, P.001) and PCV (240.8 μm to 213.4 μm, P.01) eyes, but no significant change was noted in fellow unaffected eyes. Reduction in choroidal thickness was associated with elevated C-reactive protein (odds ratio [OR]: 1.4, P = .04) and smoking (OR: 7.6, P = .03) at baseline, but not with age, refractive error, diagnosis of typical AMD or PCV, number or type of anti-VEGF injections, PDT therapy, or baseline choroidal thickness.A significant reduction in subfoveal choroidal thickness was noted after anti-VEGF therapy in typical AMD and PCV. Choroidal thickness changes were similar despite differences in number of anti-VEGF treatment.