Ultrathin Descemet stripping automated endothelial keratoplasty.

Abstract

Endothelial keratoplasty has evolved tremendously since its inception. Thick Descemet stripping automated endothelial keratoplasty (DSAEK) grafts have made sway for slimmer ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK). This review discusses the recent literature comparing outcomes of UT-DSAEK, DSAEK, and Descemet membrane endothelial keratoplasty (DMEK). DMEK provides quick visual recovery and has remarkably low incidence of graft rejection. However, the learning curve is long compared to DSAEK. UT-DSAEK utilizes donor grafts less than 100-μm thick. Recent studies comparing DMEK and UT-DSAEK have shown DMEK has better visual outcomes with similar rejection rates. UT-DSAEK remains an excellent surgical option for endothelial keratoplasty in eyes with complex anterior segment anatomy. The visual outcomes after UT-DSAEK have been shown to be superior when compared with DSAEK. Recent studies show that DMEK provides better visual outcomes compared with UT-DSAEK.