Cornea

Management of Corneal Perforations

Key Concepts Prevention of corneal perforations is of paramount importance. Aggressive lubrication, punctal occlusion, bandage soft contact lenses, tarsorrhaphy, amniotic membrane tissue, and conjunctival flaps may help prevent impending perforations from perforating. Corneal perforations are ophthalmic emergencies that may require…

Cultivated Corneal Endothelial Cell Transplantation

Key Concepts Animal-model experiments showed that a cell-injection therapy combined with the use of a Rho-associated protein kinase (ROCK) inhibitor promotes cultured corneal endothelial cell (CEC) adhesion onto the posterior cornea, ultimately resulting in the recovery of corneal transparency. The…

Complex Endothelial Keratoplasty

Key Concepts Endothelial keratoplasty (EK) offers many advantages over penetrating keratoplasty (PK) and should be attempted instead of PK whenever possible. Descemet membrane endothelial keratoplasty (DMEK) offers many advantages over Descemet stripping endothelial keratoplasty (DSEK) and should be attempted instead…

Outcomes of Descemet Membrane Endothelial Keratoplasty

Key Concepts Descemet membrane endothelial keratoplasty (DMEK) offers improved functional results over many other techniques for posterior lamellar surgery. DMEK reconstitutes normal corneal anatomy. DMEK eliminates interface problems and reduces higher order aberrations of the posterior surface. DMEK grafts can…

Outcomes of Descemet Stripping Automated Endothelial Keratoplasty

Key Concepts Descemet stripping (automated) endothelial keratoplasty (DSEK/DSAEK) provides rapid visual recovery. Postoperative complications can be minimized with careful intraoperative technique. DSEK/DSAEK yields 20/25–20/30 vision 1–3 years after surgery. DSEK/DSAEK causes minimal refractive change. DSEK/DSAEK maintains a physiologic corneal surface…

Nanothin Descemet Stripping Automated Endothelial Keratoplasty

Key Concepts While early studies found conflicting results, most recent studies have concluded better visual acuity outcomes with thinner Descemet stripping automated endothelial keratoplasty (DSAEK) tissue. With a newer preparation technique to produce DSAEK grafts with thickness ≤50 μm, we…

Ultrathin Descemet Membrane Endothelial Keratoplasty

Key Concepts Descemet membrane endothelial keratoplasty (DMEK) is not suitable for all eyes. Central thickness of Descemet stripping automated endothelial keratoplasty (DSAEK) grafts may influence the visual results. A single- or double-pass technique can be used to reproducibly obtain DSAEK…