Descemet's stripping automated endothelial keratoplasty: innovations in surgical technique

Abstract

Endothelial transplantation has supplanted penetrating keratoplasty as the procedure of choice for endothelial dysfunction. Its recent widespread acceptance has encouraged innovation in the field in an attempt to offer faster, better surgery to a broader number of patients while reducing surgical risk. This review focuses on the best studied and the most widely used form; Descemet's stripping automated endothelial keratoplasty (DSAEK). Recent advances in endothelial keratoplasty include expansion of indications, modification in host preparation, and proliferation of insertion techniques. DSAEK has been successfully used in postpenetrating keratoplasty, ICE syndrome, aniridia, aphakia, complex anterior chambers with anterior chamber lenses, and pediatric patients. Innovations in endothelial keratoplasty have broadened its use, improved intraoperative ease, and reduced postoperative complication. As we make this surgical procedure faster and easier, surgeons must critically evaluate the impact of these modifications on long-term patient outcomes.