Evolving Techniques in Partial Endothelial Keratoplasty: A Comprehensive Literature Review

Abstract

Individuals with endothelial disorders such as Fuchs’ corneal dystrophy and bullous keratopathy require corneal transplantation of the diseased corneal tissue once their endothelial cell density has decreased significantly. In the past century, penetrating keratoplasty (PK) or full corneal transplantation has been the most widely used procedure to treat endothelial dysfunction. However, endothelial keratoplasty (EK) has replaced PK as it has lower post-operative complications. EK consists of Descemet’s stripping endothelial keratoplasty (DSEK) and Descemet’s membrane endothelial keratoplasty (DMEK). This study consists of a literature review on the advantages and disadvantages of DMEK and DSEK and their post-operative complications. Patients who undergo the DMEK procedure experience lower rates of graft rejection, more frequent re-bubbling and follow-up appointments, and faster visual recovery period. Patients who undergo the DSEK procedure have higher rates of graft rejection, longer visual recovery period, and less re-bubbling rates and follow-up appointments. Surgical techniques for repairing endothelial dysfunction are evolving, but we need larger long-term studies to prove that new techniques are superior to the current surgical techniques.