Grafts of the cornea in pediatrics

Abstract

Introduction. Transplantation of the cornea in pediatrics remains a challenge. In 2008, Edward Wilson, from South Carolina, relates that the keratoplasty with the stem cell transplantation around the cornea induces the immune modulation and allows only a part of the cornea to be grafted and being more beneficial in the adults. All these advances improve the transplantation of the cornea in the children. However, new surgical methods are not available for the small pacients. In 2007, Edward J. Holland, a professor at the Department of Ophthalmology, University of Cincinnati, USA, says that the children are difficult to investigated because they do not complain about their symptoms as an adult, and their immune system increases the chance of a transplant rejection. That's reason of the keratoplasty in the adults is in progress. He also mentions that the endothelial keratoplasty can be used whether the Descemets base layer is intact. Currently, in the Republik of Moldova, from 2012, specialists prepare the various grafts in the Bank of Human Tissues, such as bone, tendon, skin, amniotic membrane, stem cells and cornea,. In 2013, the first transplant of the cornea was successful in the Municipal Clinical Hospital "H. Trinity". The most of the grafts of the cornea was transplanted in the adults using the transfexing and endothelial lamellar keratoplasty. The children are less likely to have surgery, the causes of which are the technical deficits. In the Medical Center "Ovisus" two children with the age over 11 years old were operated. The diagnoses was "Penetration of the cornea with the foreign bodies". The cornea were released from the Human Tissue Bank and had a number of over 2700 endothelial cells per mm2, useful for transfusion keratoplasty. The dynamic results of transplantation are positive with the restoration of the vision. Conclusions. The development of the associations of eye banks enables us to promote new techniques of the sampling and preservation of the cornea, which allow us to maintain the quality of the graft, and the pediatric ophthalmology will increase the spectrum of the surgical interventions.