Corneal Transplantation has undergone several advances over the past 2 decades. From full thickness penetrating keratoplasty (PK) to Deep Lamellar Endothelial Keratoplasty (DLEK – Dr. Mark Terry), Descemet’s Membrane Endothelial Keratoplasty (DSEK – Drs. Garrett Melles and Frank Price), DSAEK (“A” for Automated – Dr. Mark Gorovoy), Descemet’s Membrane Endothelial Keratoplasty (DMEK – Drs. Garrett Melles and Frank Price) and now, Pre-descemet’s Endothelial Keratoplasty (PDEK – Dr. Amar Agarwal).
Potential advantages of PDEK, this latest version of endothelial keratoplasty include:
a) ability to use younger donor tissue in comparison to DMEK
b) a more predictable learning curve and procedure (my opinion) over DMEK
c) ability to manipulate a more robust donor tissue (addition of Dua’s Layer), particularly when combined with air pump – unlike DMEK
d) potentially more forgiving if there is overlap with residual host Descemet’s membrane
e) reduced need for SF6 and fewer re-bubbling procedures in comparison to DMEK
Disadvantages of PDEK
a) tissue preparation learning curve (for surgeon or Eye Bank)
b) donor size is usually a little less than 7mm in diameter[/fusion_text]
