The transition from penetrating keratoplasty to endothelial keratoplasty during the past 2 decades has been a dramatic improvement in the treatment of patients with corneal endothelial disease. With the introduction of Descemet membrane endothelial keratoplasty (DMEK), we are approaching the goal of pure endothelial cell transplantation. In this issue of JAMA Ophthalmology, Baydoun et al1 present endothelial cell data from the original DMEK cohort. As endothelial cell function is critical for corneal clarity, endothelial cell loss is important. Examination of decreasing endothelial cell density (ECD) over time after DMEK should help us to compare this technique with penetrating keratoplasty and Descemet stripping automated endothelial keratoplasty and to predict long-term corneal transplant survival.
Sugar A. The Importance of Corneal Endothelial Cell Survival After Endothelial Keratoplasty. JAMA Ophthalmol. 2015;133(11):1285-1286. doi:10.1001/jamaophthalmol.2015.3075