Infant- and young-donor keratoplasty has its particular challenges. For example, penetrating keratoplasty can reject, as with Descemet stripping endothelial keratoplasty, and Descemet membrane endothelial keratoplasty cannot be performed until donors are at least 40 years of age. In this video, the authors demonstrate a new technique — pre-Descemet stripping endothelial keratoplasty (PDEK) — that has significant potential in this scenario.