Abstract
Endothelial keratoplasty (EK) has emerged as a leading surgical approach for the treatment of endothelial failure. Descemet′s membrane endothelial keratoplasty (DMEK) have advantages of improved visual outcomes and decreased rejection rates over the more widely used Descemet stripping automated endothelial keratoplasty (DSAEK), which produces a thicker graft that includes an additional layer of overlying stromal tissue. However, DMEK is difficult to isolate, manipulate and insert such a delicate layer of tissue without causing endothelial cell damage. Pre-Descemet′s automated endothelial keratoplasty (PDAEK) is a DMEK and DSAEK hybrid technique, in which a lamellar dissection of the donor tissue is made with a microkeratome. The central 6.5 mm thin stroma is then separated from the Pre-Descemet′s membrane using big bubble technique and excised. This newer graft configuration allows visual outcomes equivalent to DMEK with the relative surgical ease of DSAEK. Key words: Endothelial keratoplasty; Pre-Descemet′s membrane; Deep anterior lamellar keratoplasty
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