Key Concepts Therapeutic keratoplasty is indicated for recalcitrant infectious, inflammatory, or noninflammatory conditions of the cornea, including trauma, which threaten the integrity of the globe. Penetrating and lamellar are the two types of therapeutic keratoplasty, and each has advantages and…
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…
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…
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…
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…
Key Concepts Descemet membrane endothelial keratoplasty (DMEK) provides excellent visual outcomes and minimal failure rates with proper surgical technique. Damage to donor tissue during graft preparation can be reduced by decreasing mechanical stress. Common intraoperative challenges include difficulty handling and…
Key Concepts A closed-system injector is ideal for controlled delivery of a Descemet membrane endothelial keratoplasty (DMEK) graft. Creating a recipient stromal bed of slightly greater diameter than the donor graft improves graft attachment. Creating a peripheral iridotomy aids in…
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…
Key Concepts To review intraoperative and postoperative complications of Descemet stripping automated endothelial keratoplasty (DSAEK). The authors discuss endothelial keratoplasty trends followed by an outline of complications that may occur during surgery and complications that may occur days to months…
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…