Endothelial Keratoplasty Update 2020

Cornea. 2021 May 1;40(5):541-547. doi: 10.1097/ICO.0000000000002565.


Endothelial keratoplasty has revolutionized the treatment of corneal endothelial dysfunction and lowered the threshold for treatment by providing rapid visual rehabilitation and setting a high standard for safety and efficacy. Over time, endothelial keratoplasty techniques have evolved toward the use of thinner tissue to optimize visual outcomes; refinements have facilitated donor tissue preparation, handling, and attachment; and adaptations have expanded utilization in eyes with challenging ocular anatomy. Despite early concerns about graft longevity, emerging 10-year endothelial cell loss and graft survival data have been encouraging. A shortage of human donor corneas restricts utilization in many areas of the world and is driving a search for keratoplasty alternatives. Further work is needed to expand the donor supply, minimize impediments to adoption, optimize graft survival, and improve refractive predictability.

Publication types

  • Review

MeSH terms

  • Cell Count
  • Corneal Endothelial Cell Loss / physiopathology
  • Descemet Stripping Endothelial Keratoplasty / trends*
  • Endothelium, Corneal / transplantation*
  • Fuchs' Endothelial Dystrophy / physiopathology
  • Fuchs' Endothelial Dystrophy / surgery*
  • Graft Survival / physiology
  • Humans
  • Keratoplasty, Penetrating / trends*
  • Refraction, Ocular / physiology
  • Tissue Donors
  • Visual Acuity / physiology