Pediatric Keratoplasty
Optimal donor tissue selection also remains controversial and, in some areas, dependent on the availability of corneal grafts. Our preference is to use healthy tissue from young donors aged 4-30 years in pediatric penetrating keratoplasty.Using corneas from donors younger than 3 years can lead to an increase in steepness of the final graft curvature, especially if the graft is oversized by 0.5 mm or more. A steep graft might be advantageous in unilaterally aphakic patients, however, to reduce anisometropia. A young donor cornea from a donor aged 0-5 years can result in a more unpredictable refractive error and may be more prone to rejection in adults undergoing keratoplasty, and one might anticipate similar difficulties with pediatric patients. Although donor endothelial cell count has not been reported to affect graft survival, a minimum cell count should be approximately 3000 cells per mmor more.
Optimal donor tissue selection also remains controversial and, in some areas, dependent on the availability of corneal grafts. Our preference is to use healthy tissue from young donors aged 4-30 years in pediatric penetrating keratoplasty.Using corneas from donors younger than 3 years can lead to an increase in steepness of the final graft curvature, especially if the graft is oversized by 0.5 mm or more. A steep graft might be advantageous in unilaterally aphakic patients, however, to reduce anisometropia. A young donor cornea from a donor aged 0-5 years can result in a more unpredictable refractive error and may be more prone to rejection in adults undergoing keratoplasty, and one might anticipate similar difficulties with pediatric patients. Although donor endothelial cell count has not been reported to affect graft survival, a minimum cell count should be approximately 3000 cells per mmor more.