Normal endothelial cell function is imperative for maintaining the corneal transparency. Various endothelial keratoplasty techniques have evolved over the last 2 decades and have shown to aid in the provision of potential vision by endothelial transplantation [1–4]. Although major complications of penetrating keratoplasties like suture inflammation, irregular astigmatism, and keratitis are prevented after endothelial keratoplasties, they are not free of complications . In this chapter, we have discussed the complications of Pre-Descemet’s endothelial keratoplasty (PDEK) and the methods of management of the same. Pre-Descemet’s endothelial keratoplasty (PDEK), a recent modification of endothelial keratoplasty, involves the transplantation of the pre-Descemet’s layer (Dua’s layer) along with the Descemet’s membrane (DM) with endothelium [6, 7]. PDEK has many potential advantages over other EKs such as Descemet’s membrane endothelial keratoplasty (DMEK) or Descemet’s stripping and endothelial keratoplasty (DSEK); however, in the learning curve, complications are inevitable. These complications are generally manageable, and the risk tends to decline as a surgeon gains experience in the new surgical technique.
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