Endothelial Keratoplasty Versus Penetrating Keratoplasty
The gold standard surgery for corneal disease was penetrating keratoplasty (PK) until the concept of lamellar keratoplasty was described in 1914. This changed the indications and surgical options for corneal disease. Endothelial keratoplasty (EK) began as early as 1998, and research in instrumentation and procedure was carried on to make EK simpler with better postoperative results, and it evolved from posterior lamellar keratoplasty (PLK) to deep lamellar endothelial keratoplasty (DLEK), Descemet stripping endothelial keratoplasty (DSEK), Descemet stripping automated endothelial keratoplasty (DSAEK), Descemet’s membrane endothelial keratoplasty (DMEK), and finally pre-Descemet endothelial keratoplasty (PDEK) [1–15]. Ancillary techniques include, among others, the endoilluminator-assisted DMEK/PDEK (E-DMEK/E-PDEK) [16, 17] and the air-pump-assisted PDEK techniques . Though a clear cornea can be achieved in both penetrating keratoplasty (Fig. 4.1) and endothelial keratoplasty (Fig. 4.2a, b), each surgery has its own merits and demerits, and a comparison of indications, surgical technique, complications, and results of both surgeries is important.
KeywordsPenetrate Keratoplasty Endothelial Cell Loss Donor Cornea Descemet Strip Automate Endothelial Keratoplasty Endothelial Keratoplasty
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