January 2013

Descemet Membrane Endothelial KeratoplastyThe Taming of the Shrew

Author Affiliations

Author Affiliation: Department of Ophthalmology, University of Cologne, Germany.

JAMA Ophthalmol. 2013;131(1):88-89. doi:10.1001/jamaophthalmol.2013.609

Corneal transplant surgery has been revolutionized in recent years. Whereas full-thickness penetrating keratoplasty has been the standard way of treating diseased corneas for over 100 years, recent advances in lamellar corneal surgery have opened up the way toward minimally invasive and selective corneal transplant surgery.

Deep anterior lamellar keratoplasty (DALK) now allows for selective replacement of anterior stroma in stromal dystrophies and keratoconus without replacing the healthy Descemet membrane and endothelium. According to a recent technology assessment by the American Academy of Ophthalmology, DALK is as effective as and probably safer than penetrating keratoplasty.1

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