Descemet Stripping Automated Endothelial Keratoplasty Using Infant Donor Tissue

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Purpose:The purpose of this study was to report the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) surgery using infant (2 years and younger) donor tissue.Methods:Retrospective interventional case series of 3 patients.Results:All 3 patients in this series had good visual outcomes and clear DSAEK grafts. The average endothelial cell count (ECC) from infant donors was very high (4239 cells/mm2). Similarly, the average postoperative ECC was also high (3359 cells/mm2) with a mean endothelial cell loss of 20.9% at 11-month follow-up. One patient remarkably had an ECC of 4065 cells per square millimeter at 1-year follow-up with a net endothelial cell loss of only 13.3%. No difficulties were noted using infant donor tissue, including the intraoperative use of the Moria microkeratome to prepare the DSAEK donor, insertion of the donor graft, or with air-bubble management.Conclusions:Using infant donor tissue for DSAEK surgery is safe and may be preferable, particularly for younger patients. The higher preoperative endothelial cell densities in infant donor tissue should improve graft survival and long-term maintenance of corneal transparency provided that surgery-related endothelial cell loss is minimized.

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