helmholtzeyeinstituteРоссийский офтальмологический журналRussian Ophthalmological Journal2072-00762587-5760Real time Publishers10.21516/2072-0076-2025-18-2-90-94helmholtzeyeinstitute-1799Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESСравнительный анализ результатов хирургического лечения при аномалии Петерса и склерокорнеа у детей младшего возрастаComparative analysis of the results of surgical treatment for Peters anomaly and sclerocornea in young childrenПлесковаА. В.PleskovaA. V.

Плескова Алла Вячеславовна — д-р мед. наук, старший научный сотрудник отдела патологии глаз у детей.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Alla V. Pleskova — Dr. of Med. Sci., senior researcher, department of eye pathology in children.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

ГетадарянВ. Р.GetadaryanV. R.

Гетадарян Востан Рафаелович — канд. мед. наук, научный сотрудник отдела патологии глаз у детей.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Vostan R. Getadaryan — Cand. of Med. Sci., researcher, department of eye pathology in children.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

vostan11@gmail.comhttps://orcid.org/0000-0003-2103-1570ПановаА. Ю.PanovaA. Yu.

Панова Анна Юрьевна — канд. мед. наук, научный сотрудник отдела патологии глаз у детей.

ул. Садовая-Черногрязская, д. 14/19, Москва, 105062

Anna Yu. Panova — Cand. of Med. Sci., researcher, department of eye pathology in children.

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062

ФГБУ «НМИЦ глазных болезней им. Гельмгольца» Минздрава РоссииРоссияHelmholtz National Medical Research Center of Eye DiseasesRussian Federation2025140620251829094Copyright © Плескова А.В., Гетадарян В.Р., Панова А.Ю., 20252025Плескова А.В., Гетадарян В.Р., Панова А.Ю.Pleskova A.V., Getadaryan V.R., Panova A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://roj.igb.ru/jour/article/view/1799

Цель работы — изучить и сравнить результаты первичной сквозной кератопластики (СКП) у детей младшего возраста с аномалией Петерса и склерокорнеа. Материал и методы. Показатели «выживаемости» трансплантата после первичной СКП изучены у 58 детей (67 глаз) в возрасте до 5 лет с врожденным помутнением роговицы при аномалии Петерса (43 пациента) и склерокорнеа (15 пациентов). Биологический результат операции оценивали методом Каплана — Майера, с помощью которого определяли «выживаемость» трансплантата. Функциональный результат (учитывая возраст ребенка) оценивали ориентировочно: по слежению ребенка за игрушками с определенного расстояния и методом предпочтительного взора. Удаленные во время операции роговичные диски подвергались гистологическому исследованию. Результаты. Общая «выживаемость» трансплантатов составила 68%. В конечном итоге через 2 года после операции «выживаемость» трансплантата у детей с аномалией Петерса составила 68%, а у детей со склерокорнеа только 20%, через 5 лет — 56 и 7% соответственно. Среднее время «выживания» и показатель «выживаемости» значительно различались у пациентов с аномалией Петерса и у пациентов со склерокорнеа: «время выживания» — 125,3 ± 13,9 против 36,4 ± 15,1 мес (p = 0,014), «выживаемость» — 82,5% против 20,0% (p = 0,02). Наличие васкуляризации в лимбе и на периферии роговицы, а также диаметр роговицы реципиента достоверно коррелировали с развитием отторжения трансплантата. Заключение. После СКП у пациентов в возрасте 5 лет и младше отмечена высокая «выживаемость» трансплантата при аномалии Петерса, тогда как при склерокорнеа показатель приживления трансплантата оказался низким.

Purpose: to study and compare the results of primary penetrating keratoplasty (PKP) in young children with Peters’ anomaly and sclerocornea. Material and methods. The survival rates of the graft after primary PKP were studied in 58 children (67 eyes) under 5 years of age with congenital corneal opacity in Peters’ anomaly (43 patients) and sclerocornea (15 patients). The biological result of the surgery was assessed by the Kaplan — Meier method, which was used to determine the “survival” of the graft. The functional result (taking into account the child’s age) was estimated approximately: by the child's tracking of toys from a certain distance and by the preferred gaze method. The corneal discs removed during the surgery were subjected to histological examination. Results. The overall survival rate of the grafts was 68%. Ultimately, 2 years after surgery, graft survival in children with Peters anomaly was 68%, while in children with sclerocornea it was only 20%; after 5 years, it was 56% and 7%, respectively. The mean survival time and survival rate differed significantly in patients with Peters anomaly and in patients with sclerocornea: survival time 125.3 ± 13.9 versus 36.4 ± 15.1 months (p = 0.014), survival — 82.5% versus 20.0% (p = 0.02). The presence of vascularization in the limbus and on the periphery of the cornea, as well as the diameter of the recipient’s cornea, significantly correlated with the development of graft rejection. Conclusion. After PKP, high graft survival was observed in patients aged 5 years and younger with Peters anomaly, whereas graft survival was low in patients with sclerocornea.

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The authors declare that there are no conflicts of interest present.