Editing Corneal transplantation (section)

===DSEK/DSAEK/DMEK===
Endothelial keratoplasty (EK) was introduced by Melles et al. in 1998. Today there are two forms of EK:<ref>{{cite journal|title=Endothelial Keratoplasty Update 2020|journal=Cornea|last1=Price|first1=Marianne O.|last2=Feng|first2=Matthew T.|last3=Price|first3=Francis W.|volume=40|issue=5|date=May 2021|pages=541–547|doi=10.1097/ICO.0000000000002565|pmid=33252380|doi-access=free}}</ref>
* Descemet's Stripping (Automated) Endothelial Keratoplasty (DSEK/DSAEK) in which the diseased [[Descemet's membrane]] is removed and replaced by a healthy donor posterior transplant. The transplant tissue can be prepared by a surgeon's hand or ordered already prepared for surgery. Ocular Systems was the first organization to deliver prepared grafts for surgery in 2005.<ref>{{Cite web |url=http://www.ocularsystemsinc.com/physicians/services.htm |title=''Ocular Systems Company Website'' |access-date=19 March 2010 |archive-url=https://web.archive.org/web/20130929120919/http://www.ocularsystemsinc.com/physicians/services.htm/ |archive-date=29 September 2013 |url-status=dead }}</ref> DSEK/DSAEK uses only a small incision that is either self-sealing or may be closed with a few sutures. The small incision offers several benefits over traditional methods of corneal transplant such as penetrating keratoplasty.  Because the procedure is less invasive, DSAEK leaves the eye much stronger and less prone to injury than full-thickness transplants.  New medical devices such as the EndoSaver (patent pending) are designed to ease process of inserting endothelial tissue into the cornea.<ref>Evans, Matt. [http://triad.bizjournals.com/triad/stories/2009/02/09/story12.html ''Triad Business Journal''], 6 February 2009.</ref>  Additionally, DSAEK has a more rapid rate of visual recovery. Vision is typically restored in one to six months rather than one to two years.
* Descemet Membrane Endothelial Keratoplasty (DMEK) is the most recent EK technique in which an isolated Descemet's membrane is transplanted. The DMEK procedure is a 'like for like' replacement of the diseased part of the cornea with visual rehabilitation to 20/40 or better in 90% of cases and 20/25 or better in 60% of cases within the first three months. Rejection rates are lower (1%) and visual recovery is faster than any other form of corneal transplantation. In the UK (2013) DMEK is available to patients under the National Health Service at the Royal Shrewsbury Hospital,<ref>{{Cite web |url=http://www.sath.nhs.uk/media/news_archive/Pioneering-eye-surgery.aspx |title=Shrewsbury and Telford Hospital NHS Trust Website |access-date=8 June 2011 |archive-url=https://web.archive.org/web/20110725123706/http://www.sath.nhs.uk/media/news_archive/Pioneering-eye-surgery.aspx |archive-date=25 July 2011 |url-status=dead }}</ref> the Calderdale and Huddersfield NHS Trust,<ref>[http://www.cht.nhs.uk/services/clinical-services-a-z/surgery-anaesthetics/ophthalmic-services/ "Calderdale and Huddersfield NHS Trust website"]</ref> and at Worthing Hospital (Western Sussex Hospitals NHS Foundation Trust).<ref>[http://www.worthingherald.co.uk/news/health/health-news/yapton-woman-s-sight-restored-by-pioneering-surgery-1-6426761/ Worthing Herald News, 21 Nov 2014]</ref>

Not all patients with diseased corneas are candidates for endothelial keratoplasty.  These procedures correct corneal endothelial failure, but are not able to correct corneal scarring, thinning, or surface irregularity. There is currently limited data on long-term survival of DMEK grafts however the early indications are very positive. An upcoming systematic review will seek to compare the safety and effectiveness of DMEK versus DSAEK in people with corneal failure from [[Fuchs' dystrophy|Fuchs' endothelial dystrophy]] and [[Bullous keratopathy|pseudophakic bullous keratopathy]].<ref name="Stuart">{{cite journal |vauthors=Stuart AJ, Virgili G, Shortt AJ|title= Descemet's membrane endothelial keratoplasty versus Descemet's stripping automated endothelial keratoplasty for corneal endothelial failure |journal=Cochrane Database Syst Rev|issue=3|pages= CD012097 |date=2016 |doi= 10.1002/14651858.CD012097|doi-access=free}}</ref>