Abstract:

Endothelial keratoplasty (EK) is a new surgical treatment for endothelial diseases. Descemet’s membrane endothelial keratoplasty (DMEK) is the most advanced technique which provides an anatomically exact replacement of dysfunctional host endothelium and now provides better vision with lower risk of immunologic rejection. Therefore, this new technique has received high attention. However, DMEK required more challenging dissection, advanced techniques of excision of host posterior stoma tissue and need long learning curve. Initially，the biggest challenges were tissue loss in preparation and ensuring attachment. Recently, some eye banks have prepared grafts of donor tissue that may help the surgeon avoid the risk of tissue loss. Furthermore, a new bimanual technique for insertion and positioning of the grafts in DMEK that may prevent the risk happening. Now DMEK has been widely applied in developed countries. In China, there are still no reports of DMEK because of the lack of donor tissue.