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Endothelial Keratoplasty: A Revolution in Evolution

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SURVEY OF OPHTHALMOLOGY
卷 57, 期 3, 页码 236-252

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.survophthal.2011.10.005

关键词

Endothelial keratoplasty; Descemet's stripping endothelial keratoplasty; Descemet's membrane endothelial keratoplasty; posterior lamellar keratoplasty; DMEK; DSAEK; DMAEK

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Endothelial keratoplasty (EK) is continually evolving both in surgical technique and clinical outcomes. Descemet's stripping endothelial keratoplasty (DSEK) has replaced penetrating keratoplasty (PK) as the treatment of choice for corneal endothelial dysfunction. It is safe and predictable and offers early visual rehabilitation. Newer iterations include Descemet's membrane endothelial keratoplasty, Descemet's membrane automated endothelial keratoplasty, and other hybrid techniques. Early data on these newer EK techniques suggests that they provide significantly better visual outcomes compared to DSEK. Initial 5-year survival data indicates that EK is at least comparable to PK, and more widespread survival data is anticipated. Further work is needed to simultaneously optimize visual outcomes, refractive predictability, and endothelial cell survival, as well as surgical techniques of donor preparation and insertion. (Surv Ophthalmol 57:236-252, 2012. (C) 2012 Elsevier Inc. All rights reserved.)

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