Stepwise approach ideal for pre-Descemet’s endothelial keratoplasty

Endothelial keratoplasty has revolutionized the surgical approach for corneal endothelial disorders that are normally not well managed with a medical line of treatment and often necessitate a surgical approach.Pre-Descemet’s endothelial keratoplasty (PDEK) is a newer option among the variants of endothelial keratoplasty; it essentially requires the transplantation of the pre-Descemet’s layer in association with the Descemet’s membrane-endothelium complex. OCT studies have demonstrated the thickness of the PDEK donor graft to be approximately 30 µm to 35 µm with both adult and infant donor tissue. The addition of the pre-Descemet’s layer to the Descemet’s membrane-endothelium complex acts as a splint that provides better support and tissue unrolling of the donor graft in the recipient’s eye.