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Review
. 2021 May 1;40(5):541-547.
doi: 10.1097/ICO.0000000000002565.

Endothelial Keratoplasty Update 2020

Marianne O Price  1 , Matthew T Feng  2 , Francis W Price Jr  2
Affiliations
Review

Endothelial Keratoplasty Update 2020

Marianne O Price et al. Cornea. .

Abstract

Endothelial keratoplasty has revolutionized the treatment of corneal endothelial dysfunction and lowered the threshold for treatment by providing rapid visual rehabilitation and setting a high standard for safety and efficacy. Over time, endothelial keratoplasty techniques have evolved toward the use of thinner tissue to optimize visual outcomes; refinements have facilitated donor tissue preparation, handling, and attachment; and adaptations have expanded utilization in eyes with challenging ocular anatomy. Despite early concerns about graft longevity, emerging 10-year endothelial cell loss and graft survival data have been encouraging. A shortage of human donor corneas restricts utilization in many areas of the world and is driving a search for keratoplasty alternatives. Further work is needed to expand the donor supply, minimize impediments to adoption, optimize graft survival, and improve refractive predictability.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

References

    1. Melles GR, Eggink FA, Lander F, et al. A surgical technique for posterior lamellar keratoplasty. Cornea. 1998;17:618–626.
    1. Melles GR, Wijdh RH, Nieuwendaal CP. A technique to excise the Descemet membrane from a recipient cornea (descemetorhexis). Cornea. 2004;23:286–288.
    1. Price FW Jr, Price MO. Descemet's stripping with endothelial keratoplasty in 50 eyes: a refractive neutral corneal transplant. J Refract Surg. 2005;21:339–345.
    1. Gorovoy MS. Descemet-stripping automated endothelial keratoplasty. Cornea. 2006;25:886–889.
    1. Price MO, Baig KM, Brubaker JW, et al. Randomized, prospective comparison of precut vs surgeon-dissected grafts for Descemet stripping automated endothelial keratoplasty. Am J Ophthalmol. 2008;146:36–41.

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