Intraoperative slit lamp improves visualization of anterior chamber through cloudy cornea in DMEK

Endothelial keratoplasty has revolutionized corneal transplantation with the elimination of full-thickness corneal wounds and suture reduction to a single suture for the temporal corneal wound. Such advancement was possible because of the air bubble-assisted attachment of the donor corneal tissue to the recipient inner corneal stromal surface without the need for corneal sutures. Currently, Descemet’s membrane endothelial keratoplasty has been of great interest to corneal surgeons globally. Further, eye banks have been involved with donor tissue that is ready to use in the operating room, thus simplifying the surgical steps for corneal surgeons in performing endothelial keratoplasty. Industry involvement with improved surgical instruments, partial-thickness trephines and donor tissue delivery systems to introduce the donor corneal disc into the recipient anterior chamber has also assisted and refined surgical techniques, all of which translates into improved postoperative outcomes, augmented visual quality and faster visual recovery for our patients who undergo endothelial keratoplasty.The future of corneal transplantation is also bright, with in vitro tissue-engineered expansion of donor endothelial cells, pure donor endothelial cell transplantation via injection conduit, and also chemically induced augmentation of existing endothelial cells within the patient’s cornea. Thus, the combined efforts of researchers, corneal surgeons, eye banks and industry all amalgamate and translate into taking modern day corneal transplantation to yet another level of sophistication and improved visual quality.