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EK (DLEK, DSEK, DMEK): New Frontier in Cornea Surgery

EK (DLEK, DSEK, DMEK): New Frontier in Cornea Surgery Endothelial keratoplasty (EK) has revolutionized treatment of corneal endothelial dysfunction. Compared with penetrating keratoplasty (PK), EK provides faster and more reliable visual rehabilitation while maintaining the eye's structural integrity. The number of EK procedures is growing annually and surpassed PK in the United States in 2012. The most widely used iteration, Descemet stripping endothelial keratoplasty (DSEK), implants healthy donor endothelium, Descemet membrane, and posterior stroma. Descemet membrane endothelial keratoplasty (DMEK) eliminates the donor stromal layer. Although more surgically challenging than DSEK, DMEK provides even faster visual rehabilitation and reduced risk of immunologic rejection, so its use is growing. Potential future alternatives to EK that could help address the unmet demand for donor corneas include removing central guttae and regenerating a central endothelial cell layer from healthy peripheral cells in patients with Fuchs dystrophy or injecting cultured human corneal endothelial cells to rehabilitate eyes without residual healthy endothelium. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annual review of vision science Annual Reviews

EK (DLEK, DSEK, DMEK): New Frontier in Cornea Surgery

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Publisher
Annual Reviews
Copyright
Copyright 2017 by Annual Reviews. All rights reserved
ISSN
2374-4642
eISSN
2374-4650
DOI
10.1146/annurev-vision-102016-061400
pmid
28697678
Publisher site
See Article on Publisher Site

Abstract

Endothelial keratoplasty (EK) has revolutionized treatment of corneal endothelial dysfunction. Compared with penetrating keratoplasty (PK), EK provides faster and more reliable visual rehabilitation while maintaining the eye's structural integrity. The number of EK procedures is growing annually and surpassed PK in the United States in 2012. The most widely used iteration, Descemet stripping endothelial keratoplasty (DSEK), implants healthy donor endothelium, Descemet membrane, and posterior stroma. Descemet membrane endothelial keratoplasty (DMEK) eliminates the donor stromal layer. Although more surgically challenging than DSEK, DMEK provides even faster visual rehabilitation and reduced risk of immunologic rejection, so its use is growing. Potential future alternatives to EK that could help address the unmet demand for donor corneas include removing central guttae and regenerating a central endothelial cell layer from healthy peripheral cells in patients with Fuchs dystrophy or injecting cultured human corneal endothelial cells to rehabilitate eyes without residual healthy endothelium.

Journal

Annual review of vision scienceAnnual Reviews

Published: Sep 15, 2017

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