Background: Penetrating keratoplasty is at present the gold standard for surgical treatment of corneal endothelial pathologies but tremendous progress has been made in recent years in improving the technology of (posterior) lamellar keratoplasty techniques, such as Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK).
Methods: A review of the literature was carried out using PUBMED and own clinical and experimental data.
Results: Isolated transplantation of Descemet's membrane with endothelial cells after stripping the host Descemet's membrane is a new surgical technique for Fuchs endothelial dystrophy and pseudophakic bullous keratopathy. Visual rehabilitation seems to be faster and better with DMEK compared to penetrating keratoplasty.
Conclusion: Posterior lamellar keratoplasty techniques such as DMEK will replace penetrating keratoplasty as the gold standard for treatment of a large segment of corneal endothelial pathologies.