REVIEW  MODERN TECHNIQUES OF LAMELLAR KERATOPLASTY 

Minerva Oftalmologica 2018 December;60(4):229-37

DOI: 10.23736/S0026-4903.18.01818-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Descemet membrane endothelial keratoplasty

Giuseppe GIANNACCARE ¹ ✉, Massimo BUSIN ^{2, 3, 4}

¹ Unit of Ophthalmology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; ² Department of Ophthalmology, Villa Igea Private Hospital, Forlì, Italy; ³ International Institute of Research and Education in Ophthalmology (IRFO), Forlì, Italy; ⁴ Department of Morphology, Surgery and Experimental Surgery, University of Ferrara, Ferrara, Italy

The techniques of endothelial keratoplasty have become the standard of treatment for corneal endothelial diseases. Among these, Descemet membrane endothelial keratoplasty (DMEK) is the only technique able to provide a true anatomical replacement of dysfunctional layers, using only donor Descemet’s membrane and endothelium. Since its introduction, the continue evolution of both donor preparation and graft manipulation and insertion techniques has improved the safety and outcomes of the procedure, with lower rates of primary graft failure and early postoperative detachment. However, the latter still represents the main complication that can required single or multiple rebubbling procedures. Overall, DMEK provides better refractive and visual outcomes, faster rehabilitation and lower risk of immunologic rejection compared to Descemet stripping automated endothelial keratoplasty.

KEY WORDS: Descemet stripping endothelial keratoplasty - Corneal injuries - Review