[Penetrating keratoplasty in children]. / La greffe de cornéee chez l'enfant.

Penetrating keratoplasty in children is a high risk transplantation. Indications increased with improvement of surgical techniques and therapies. Our purpose is to study anatomic and functional results of penetrating keratoplasty in children. We report the results of a retrospective study including 23 penetrating keratoplasties (22 eyes) performed in 20 patients younger than 16 years old, between 1991 and 2000 at the department of ophthalmology at Charles Nicolle University Hospital-Tunis. Penetrating keratoplasty was performed for congenital dystrophies in 6 cases (17.3%), for acquired traumatic opacities in 4 cases (26%) and for non traumatic acquired opacities in 13 cases (56.7%). Non traumatic acquired opacities were keratoconus in 8 cases (61.5%), keratitis in 3 cases (23%) and graft rejection in 2 cases (15.5%). The mean follow-up was 41.8 months. Grafts remained clear in 20 cases (83.3%). Graft rejection occurred in 4 cases. Graft failure occurred in 3 cases (16.6%). Mean postoperative visual acuity was 3/10 (ranging from 1/20 to 7/10). Penetrating keratoplasty in children allows a satisfying anatomic success but a moderate visual improvement. Amblyopia is the major obstacle to success in children corneal grafting.

[Visual impairment in Tunisia]. / Le handicap visuel en Tunisie.

The purpose is to study visual impairment in Tunisia, its epidemiology, its etiologies and to present the major prevention measures. This study was conducted between 1992 and 1998. 1105 patients were examined in specialized outpatient clinic. Our group is composed from 712 men and et 393 women, aged 1 to 93 years. 435 patients were partially sighted and 670 were blind. Adults pathologies were dominated by acquired cataracts and adult glaucomas; diabetic retinopathy and age related macular degeneration are less frequent. Infectious ocular diseases are in constant decrease in Tunisia since 30 years. Prevention is fundamental and must be done each time it is possible. Visual reeducation should improve autonomy and familial and socio-economic reintegration of these visually impaired.