Evaluation of the Patient and Decision-Making: Posterior Lamellar Versus Penetrating Keratoplasty

Endothelial keratoplasty has revolutionized the treatment of corneal endothelial dysfunction as it leads to faster visual rehabilitation whilst maintaining the corneal architecture. Whilst DS(A)EK [Descement Stripping (Automated) Endothelial Keratoplasty] has seen massive improvements in technique modifications, DMEK (Descemet Membrane Endothelial Keratoplasty) and PDEK (Pre-Descemetic Endothelial Keratoplasty) are continuously being modified as they are being adopted by an ever growing number of surgeons. Patient evaluation is key in making the decision between posterior lamellar versus penetrating keratoplasty.