Preserving the lens important in young phakic patients undergoing DMEK

Endothelial keratoplasty, or EK, appears to be the epicenter of the corneal transplantation scene, and it has surpassed penetrating keratoplasty for the surgical correction of endothelial decompensation and corneal edema in the United States. This preferred choice of EK over PK is largely due to the superior quality of vision that returns relatively quickly after EK surgery and the lowest endothelial rejection rate as compared with other forms of corneal transplantation; in addition, the majority of the patient’s own cornea is retained without any full-thickness corneal wound, and the use of conventional sutures, for the most part, is eliminated in EK.All three segments of ophthalmic surgical care — the patient, the corneal surgeon and industry — have seemed to contribute in a positive way to make EK prominent in the corneal transplantation arena. The patient wishes for a better quality of vision to match an active lifestyle; the surgeon seeks an improved surgical procedure; and industry develops new EK instruments to facilitate the transition from full-thickness surgery to selective tissue corneal transplantation. In addition, eye banks have embraced EK procedures and are providing ready-to-use EK donor tissues for corneal surgeons. These efforts from all sides have helped EK move to the preferred procedure of choice when dealing with endothelial decompensation and corneal edema with or without associated Fuchs’ corneal dystrophy.