Abstract: Objective To analyze the disease composition of children keratoplasty. Design Retrospective case series. Participants 434 keratoplasty children (514 eyes) aged 14 years and below from Peking University Eye Center between January, 2008 and December, 2020. Method The electronic medical records of children keratoplasty were evaluated retrospectively, including gender, recipient age, disease diagnosis, surgical procedures and so on. Main Outcome Measures Composition ratio of disease and surgical procedures. Results In 434 patients, there were 225 males (51.8%). Mean primary recipient age was 3.8±4.1 years (range, 2 months-14 years), including 307 eyes (59.7%) which were less than 3 years. Of the 514 eyes accepted primary keratoplasty, 399 eyes (77.6%) were congenital corneal opacity, 47 eyes (9.1%) were acquired traumatic corneal opacity and 68 eyes (13.3%) were acquired non-traumatic corneal opacity. The main cause for keratoplasty among congenital corneal opacity was kerato-irido-lenticular dysgenesis (30.9%, 159 eyes), followed by limbal dermoid (18.7%, 96 eyes). Penetrating keratoplasty accounts for 56.6% of total keratoplaties. 60 eyes (11.7%) underwent two or more keratoplasty. Conclusion Congenital corneal opacity, especially kerato-irido-lenticular dysgenesis, is the most common disease of pediatric keratoplasty in Peking University Eye Center. Penetrating keratoplasty is the main surgical type. （Ophthalmol CHN, 2022, 31: 98-103）

Key words: keratoplasty, childhood