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Endothelial keratoplasty: is Descemet membrane endothelial keratoplasty the Holy Grail of lamellar surgery? No

Endothelial keratoplasty: is Descemet membrane endothelial keratoplasty the Holy Grail of lamellar surgery? No
Endothelial keratoplasty: is Descemet membrane endothelial keratoplasty the Holy Grail of lamellar surgery? No
Posterior lamellar surgery has transformed the management of corneal endothelial disease due to faster visual rehabilitation, minimal refractive change, and maintenance of the ocular structural integrity compared full thickness keratoplasty. Although Descemet’s membrane endothelial keratoplasty (DMEK) appears to offer an anatomical repair for endothelial pathology, replacing only endothelium and Descemet’s membrane without any posterior stroma,1 it has yet to supersede Descemet’s stripping endothelial keratoplasty (DSEK) and its variations; ultrathin Descemet’s stripping automated endothelial keratoplasty (UT-DSAEK),2,3 thin manual Descemet stripping keratoplasty (TMDSEK),4 and pre-Descemet’s endothelial keratoplasty (PDEK)5 as the mainstay the treatment of Fuchs endothelial dystrophy or bullous keratopathy. The main reason for this is that DMEK is technically more challenging, requiring prolonged surgical time, associated with a steeper learning curve and possibly more potential complications.6,7
0950-222X
Tsatos, Michael
49820135-c443-4bb0-aa7c-f602ea3207af
Liarakos, V
1e320f85-ebbf-4ad2-bdbe-ea658fdd19d3
Macgregor, C.
dea620a6-672f-4544-8307-7d2db2629226
Athanasiadis, I.
1bf6f5d1-7137-42af-866f-f76ea142bed6
Detorakis, ET
f58469d5-3413-4cd3-b332-f97ca4eb3f4e
Moschos, M
c792f479-d540-43a4-aace-54ba172bb6b2
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51
Anderson, David F
441a2220-b721-417d-b9f4-8f40ed17a621
Tsatos, Michael
49820135-c443-4bb0-aa7c-f602ea3207af
Liarakos, V
1e320f85-ebbf-4ad2-bdbe-ea658fdd19d3
Macgregor, C.
dea620a6-672f-4544-8307-7d2db2629226
Athanasiadis, I.
1bf6f5d1-7137-42af-866f-f76ea142bed6
Detorakis, ET
f58469d5-3413-4cd3-b332-f97ca4eb3f4e
Moschos, M
c792f479-d540-43a4-aace-54ba172bb6b2
Hossain, Parwez
563de5fc-84ad-4539-9228-bde0237eaf51
Anderson, David F
441a2220-b721-417d-b9f4-8f40ed17a621

Tsatos, Michael, Liarakos, V, Macgregor, C., Athanasiadis, I., Detorakis, ET, Moschos, M, Hossain, Parwez and Anderson, David F (2017) Endothelial keratoplasty: is Descemet membrane endothelial keratoplasty the Holy Grail of lamellar surgery? No. Eye. (doi:10.1038/eye.2017.51).

Record type: Article

Abstract

Posterior lamellar surgery has transformed the management of corneal endothelial disease due to faster visual rehabilitation, minimal refractive change, and maintenance of the ocular structural integrity compared full thickness keratoplasty. Although Descemet’s membrane endothelial keratoplasty (DMEK) appears to offer an anatomical repair for endothelial pathology, replacing only endothelium and Descemet’s membrane without any posterior stroma,1 it has yet to supersede Descemet’s stripping endothelial keratoplasty (DSEK) and its variations; ultrathin Descemet’s stripping automated endothelial keratoplasty (UT-DSAEK),2,3 thin manual Descemet stripping keratoplasty (TMDSEK),4 and pre-Descemet’s endothelial keratoplasty (PDEK)5 as the mainstay the treatment of Fuchs endothelial dystrophy or bullous keratopathy. The main reason for this is that DMEK is technically more challenging, requiring prolonged surgical time, associated with a steeper learning curve and possibly more potential complications.6,7

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e-pub ahead of print date: 21 April 2017

Identifiers

Local EPrints ID: 413705
URI: https://eprints.soton.ac.uk/id/eprint/413705
ISSN: 0950-222X
PURE UUID: 8500e667-b4a8-4546-8053-7a164a9157e3
ORCID for Parwez Hossain: ORCID iD orcid.org/0000-0002-3131-2395

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Date deposited: 31 Aug 2017 16:32
Last modified: 03 Dec 2019 01:47

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Contributors

Author: Michael Tsatos
Author: V Liarakos
Author: C. Macgregor
Author: I. Athanasiadis
Author: ET Detorakis
Author: M Moschos
Author: Parwez Hossain ORCID iD
Author: David F Anderson

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