Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty

Endothelial keratoplasty has replaced traditional penetrating keratoplasty for the treatment of corneal endothelial dysfunction. It offers faster, more predictable, stable visual recovery and low rejection rates while the surgery itself is less invasive. Descemet membrane endothelial keratoplasty (DMEK) is currently the gold standard for the treatment of Fuchs endothelial dystrophy, bullous keratopathy, and corneal edema after cataract surgery. Its favorable long-term outcomes are increasingly reported by large study groups. This review summarizes the current literature on new DMEK techniques, including size and shape modifications, new graft delivery techniques, and surgical pearls for challenging cases like eyes with glaucoma, glaucoma tubes, and failed penetrating keratoplasties.

Automated summary

Endothelial keratoplasty has become a preferred treatment over traditional penetrating keratoplasty due to its faster and more predictable visual recovery with lower rejection rates. Descemet membrane endothelial keratoplasty (DMEK) is now considered the gold standard for various corneal conditions, with ongoing studies focusing on new techniques and modifications for challenging cases.