Eye Bank Records on Pediatric Keratoplasty

Purpose: To report eye bank records for pediatric keratoplasty in Iran between 2006 and 2019. Methods: In a retrospective study, all electronic records of the Central Eye Bank of Iran for pediatric keratoplasty between April 2006 and March 2019 were analyzed in terms of indications for keratoplasty, surgical techniques, their corresponding trends, and post-transplantation graft clarity. Results: Our database included 2178 eyes from 2050 pediatric cases. The leading indications for keratoplasty included acquired nontraumatic diseases (75.8%), congenital abnormalities (12.7%), corneal regraft (8.3%), and acquired traumatic diseases (3.2%). Keratoconus was the most common acquired nontraumatic cause (58%) and more common in the age group >12 years than those ≤12 years (P < 0.001). Congenital corneal abnormalities and regrafts were more common in the age group ≤12 years (both Ps < 0.001). The most common surgical technique was penetrating keratoplasty (PKP, 90.9%) followed by deep anterior lamellar keratoplasty (DALK, 7.3%), Descemet stripping automated endothelial keratoplasty (DSAEK, 1.1%), anterior lamellar keratoplasty (0.5%), and keratolimbal allograft transplantation (0.2%). DSAEK was more common in the age group ≤12 years (P = 0.002), which, unlike PKP and DALK, showed a significant ascending trend over the 14-year period (P = 0.018). Posttransplantation graft clarity was 96.8%. Conclusion: Keratoconus was the leading indication for pediatric keratoplasty in Iran. Although PKP was the predominant keratoplasty procedure for the treatment of pediatric corneal disorders, it showed a significant descending trend over the 14 years.