title: The effects of donor age on the outcome of penetrating keratoplasty in adults.
abstract: OBJECTIVE
  The purpose of the study is to determine whether there is a higher incidence of complications in adult patients receiving corneas from pediatric donors compared to those receiving corneas from adult donors.
  
  
  METHODS
  The design is a follow-up of two matched cohorts.
  
  
  METHODS
  The outcome of penetrating keratoplasty in 29 adult patients (age 20 years of age and older) receiving pediatric donor corneas (range, 0-5 years) was compared to that of 29 control patients matched for recipient age and diagnosis who received adult donor corneas (range, 40-70 years).
  
  
  METHODS
  Chart review was performed.
  
  
  METHODS
  Graft rejection, postoperative keratometry, postoperative refractive cylinder, postoperative intraocular pressure, and graft failure due to rejection were measured.
  
  
  RESULTS
  One or more allograft reactions occurred in 11 (37.9%) of 29 patients who received pediatric donor corneas compared to 2 (6.9%) of 29 patients who received adult donor corneas (P = 0.005, chi-square). There were a total of 20 rejection episodes in patients receiving pediatric donor corneas compared to a total of 5 rejection episodes in patients receiving adult donor corneas. The average postoperative keratometry was 46.1 diopters for the pediatric donor group and 44.0 diopters for the adult donor group (P = 0.03). There was no statistically significant difference in average refractive cylinder (P = 1.0), intraocular pressure (P = 0.26), or the incidence of graft failure due to rejection (P = 1.0) between the two groups. The average follow-up time for clear grafts was 58.3 months in the pediatric donor group and 59.9 months in the adult donor group.
  
  
  CONCLUSIONS
  The incidence of allograft reactions and the postoperative corneal curvature is greater in adult eyes undergoing penetrating keratoplasty with young donor corneas compared to those undergoing penetrating keratoplasty with older donor corneas. There was no difference in the incidence of graft failure due to rejection between the two groups.
authors.affiliation: Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Palay
authors.forename: T A
authors.initials: TA
authors.lastname: Kangas
authors.forename: R D
authors.initials: RD
authors.lastname: Stulting
authors.forename: K
authors.initials: K
authors.lastname: Winchester
authors.forename: D
authors.initials: D
authors.lastname: Litoff
authors.forename: J H
authors.initials: JH
authors.lastname: Krachmer
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D015331:Cohort Studies; D003315:Cornea / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014019:Tissue Donors; D016896:Treatment Outcome