Does thickness matter: ultrathin Descemet stripping automated endothelial keratoplasty

Descemet stripping automated endothelial keratoplasty (DSAEK) has become worldwide the procedure of choice for the replacement of diseased corneal endothelium. More recently, ultrathin DSAEK (UT-DSAEK) has been introduced to guarantee better visual outcomes preserving good donor graft manipulation.

As DSAEK may still have major challenges such as suboptimal visual acuity and relatively slow visual rehabilitation, fairly new techniques such as UT-DSAEK and Descemet membrane endothelial keratoplasty (DMEK) have been introduced to allow much quicker and optimal visual rehabilitation. This article goes through the most recent findings and results of these techniques.

UT-DSAEK is a procedure that shares the improved visual outcome and lower immunologic rejection rate of DMEK over DSAEK, while minimizing all types of postoperative complications. In addition, similar to DSAEK and unlike DMEK, UT-DSAEK can be performed in all types of eyes, even in those with complicated anatomy or poor anterior chamber visualization.