Abstract

Aims: To evaluate the feasibility, efficacy, and postoperative complications of Descemet's stripping endothelial keratoplasty (DSEK) with pediatric donor tissue.

Methods: Retrospective noncomparative interventional case series. Seven consecutive cases (7 eyes) of pseudophakic bullous keratopathy were treated with DSEK using pediatric donor tissue and followed up for 12 to 18 months. Data collected included best spectacle-corrected visual acuity, spherical equivalent refractive error, corneal astigmatism, corneal curvature, and endothelial cell density.

Results: DSEK was successfully performed in 6 out of 7 eyes with pediatric donor graft; 1 pediatric donor graft perforated during dissection. All pediatric tissue was unfolded with "hitch suture" technique and supported with plenty of air. No graft dislocation occurred. At 12 months postoperatively, cornea was clear in all eyes; best spectacle-corrected visual acuity ranged from 20/67 to 20/32; average spherical equivalent refractive error was 1.9±0.5 diopters; average corneal astigmatism was 2.2±0.6 diopters; average corneal curvature was 45.2±1.6 diopters; and average endothelial cell density was 2247.7±74.3 cells/mm² (41.4±3.7% of endothelial cell loss).

Conclusion: With high postoperative endothelial cell counts, low graft dislocation rate, and absence of high myopic shifts, pediatric donor tissue can be successfully used in DSEK.