Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) Using Infant Donor Tissue

1. Peter Kim
2. Sonia N. Yeung
3. Alejandro Lichtinger
4. Maoz D. Amiran
5. David S. Rootman

Toronto Western Hospital, Univeristy of Toronto, Toronto, Canada

Purpose: To report the outcomes of DSAEK surgery using infant (≤ 2 years old) donor tissue.

Methods: Clinical chart review of 3 patients.

Results: All 3 patients in this series had good visual outcomes and clear DSAEK grafts. The average ECC from infant donors was very high (4239/mm2). Similarly, the average postoperative ECC was also high (3359/mm2) with a mean endothelial cell loss of 20.9% at 11 months follow-up. One patient remarkably had an ECC of 4065/mm2 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.