Ocular refraction after penetrating keratoplasty with infant donor corneas

Five adult patients underwent penetrating keratoplasty in which corneal tissue from donors 3 months old or younger was used. In each case, a large myopic shift in refraction was found after surgery (mean, 9 diopters). The average postoperative spherical equivalent was -7.35 diopters. This resulted from the extremely steep curvature of the infant donor cornea (mean keratometric value, 57.67 diopters). The induced anisometropia and steep corneal topography of the infant donor cornea prevented visual rehabilitation with spectacles or contact lenses in four of five patients. Our findings suggested that corneal tissue from donors 3 months old or younger may be unsuitable for penetrating keratoplasty in emmetropic adults or anisometropic patients undergoing surgery in the more myopic eye.