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Related Experiment Video

Updated: Mar 13, 2026

Decellularization and Recellularization Methodology for Human Saphenous Veins
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Evidence-Based Endothelial Rehabilitation.

Shaohui Liu1,2, Peter Veldman2

  • 1a Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine , Indianapolis , IN , USA.

Seminars in Ophthalmology
|October 19, 2016
PubMed
Summary

Endothelial keratoplasty (EK) offers better vision and faster recovery than penetrating keratoplasty (PKP). Graft survival is comparable, especially with experienced surgeons, suggesting EK is a superior treatment for corneal endothelial dysfunction.

Keywords:
DMEKDSAEKDSEKDescemet membraneendothelial keratoplastykeratoplasty

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Transplantation Immunology

Background:

  • Endothelial keratoplasty (EK) is now the primary surgical treatment for corneal endothelial dysfunction, largely replacing penetrating keratoplasty (PKP).
  • Recent data indicate minimal advantages of EK over PKP in graft survival and visual outcomes.

Purpose of the Study:

  • To compare the published outcomes and complications of EK versus PKP.
  • To evaluate the factors influencing the discrepancies in registry data.

Main Methods:

  • Systematic review and comparison of published studies on EK and PKP outcomes.
  • Analysis of graft survival, visual acuity, rejection rates, and patient satisfaction.

Main Results:

  • EK shows superior spectacle-corrected visual acuity, faster visual recovery, reduced graft rejection, and higher patient satisfaction, particularly in high-volume centers.
  • While early endothelial cell loss is higher in EK, long-term (5-year) graft survival and endothelial cell counts are equivalent or superior to PKP in high-volume studies.
  • Registry data suggest a potential gap in outcomes for lower-volume EK surgeons compared to high-volume centers.

Conclusions:

  • EK provides significant advantages in visual outcomes and patient experience over PKP.
  • Standardization and simplification of EK procedures may improve outcomes for lower-volume surgeons, aligning with high-volume center results.
  • EK is a highly effective treatment for corneal endothelial dysfunction, with outcomes comparable or superior to PKP, especially when performed by experienced surgeons.