Descemet's stripping automated endothelial keratoplasty: innovations in surgical technique

Abstract

Innovations in endothelial keratoplasty have broadened its use, improved intraoperative ease, and reduced postoperative complication. As we make this surgical procedure faster and easier, surgeons must critically evaluate the impact of these modifications on long-term patient outcomes.

Descemet Membrane Endothelial Keratoplasty

“…[1][2][3] Descemet membrane endothelial keratoplasty (DMEK), as introduced by the Netherlands Institute for Innovative Ocular Surgery (NIIOS), in which only the corneal endothelium and Descemet membrane are transplanted is currently the most targeted endothelial keratoplasty technique available. 4,5 After DMEK, the nearly perfect anatomical restoration of the cornea seems to allow a quick and often complete visual rehabilitation.…”

Etiopathogenesis and Therapy of Epithelial Ingrowth after Descemet’s Stripping Automated Endothelial Keratoplasty

“…In the past decade, Descemet's stripping automated endothelial keratoplasty (DSAEK) has become the chosen procedure for the management of patients with endothelial dysfunction, overtaking penetrating keratoplasty (PK) in popularity for the treatment of these specific diseases [1]. The technique was originally described by Melles et al, [2] as “posterior lamellar keratoplasty,” and was subsequently modified by Terry and Ousley [3] and renamed “deep lamellar endothelial keratoplasty.” The technique of stripping Descemet's membrane was again described by Melles et al [4] and termed “Descemet's stripping endothelial keratoplasty.” The procedure was modified again to involve the use of an automated blade microkeratome to create a lamellar dissection of the donor cornea, as described by Gorovoy and Ratanasit [5], and was termed “Descemet's stripping automated endothelial keratoplasty” (DSAEK).…”

Descemet’s Stripping-Automated Endothelial Keratoplasty for Traumatic Aniridia and Aphakia

“…Surgically challenging cases have been described in the literature including cases with Iridocorneal Endothelial Syndrome (ICE) [4], aniridia and aphakia [5], complex anterior chambers with anterior chamber lenses [6, 7], post keratoplasty [8], and pediatric patients [5, 9–11]. …”