Peng RM, Guo YX, Qiu Y, Hong J, Xiao GG, Qu HQ. Clinical outcomes after Descemet's stripping endothelial keratoplasty using donor corneas from children younger than 3 years.
Clin Exp Ophthalmol 2018;
46:721-729. [PMID:
29498188 PMCID:
PMC6221158 DOI:
10.1111/ceo.13186]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 02/16/2018] [Accepted: 02/25/2018] [Indexed: 11/28/2022]
Abstract
Importance
There is limited literature on paediatric donors in endothelial keratoplasty.
Background
This study investigated the efficacy of and appropriate paediatric donor age for Descemet’s stripping endothelial keratoplasty (DSEK).
Design
Retrospective and observational case series.
Participants
Thirty‐eight consecutive patients underwent DSEK with paediatric donor corneas.
Methods
The age of the donors ranged from 32 weeks gestation (premature neonate) to 3 years old. All donor consents were obtained from the parents. The causes of donor death included traffic accident, congenital heart disease and neonatal respiratory distress syndrome.
Main Outcome Measures
The outcome measures included best‐corrected visual acuity, endothelial cell loss and complications.
Results
Best‐corrected visual acuity at last follow‐up was >20/40 in 28 of 38 eyes (73.7%). The mean preoperative endothelial cell density of donor corneas was 4682 ± 520 cells/mm2. The mean endothelial cell density of grafts was 3977 ± 556 cells/mm2 at 18 months postoperatively. Three lenticules from premature neonate donors exhibited severe contraction postoperatively. The edge of six lenticules from donors <1‐year‐old exhibited contraction in the early postoperative period and gradually flattened spontaneously. Graft detachment occurred in one patient.
Conclusions and Relevance
DSEK with paediatric donor corneas can achieve good clinical outcomes. The corneal lenticules from 1‐ to 3‐year‐ old donors are suitable for DSEK while those from donors <1‐year‐old are less suitable due to the possibility of severe postoperative graft contraction.
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