Purpose of review
To describe trends in corneal transplantation
surgery, including indications for surgery, evolution of lamellar keratoplasty
, current surgical techniques, and future directions.
Over the past decade, anterior and posterior lamellar keratoplasty
have begun to supplant penetrating keratoplasty
. Surgical techniques continue to change and improve outcomes. In recent years, Descemet membrane endothelial keratoplasty
(DMEK) has gained interest as it eliminates the corneal stromal interface, which may limit visual acuity after Descemet stripping automated endothelial keratoplasty
. Despite the promising results with improved visual acuity and decreased rejection, the technical challenges associated with DMEK have limited widespread acceptance. With technical refinements and more eye banks providing precut tissue for both Descemet stripping automated endothelial keratoplasty
and DMEK, it is likely both procedures will continue to increase over time.
Summary Corneal transplantation
has evolved rapidly over the past decade, from full-thickness penetrating keratoplasty
towards lamellar keratoplasty
to only remove and replace damaged layers of the cornea. Achieving minimal induced astigmatism with excellent visual acuity remains a challenge in corneal transplantation
. Further refinements in surgical technique may help improve technical challenges and visual outcomes. In this article, we review changing trends in corneal transplantation
and highlight developing medical treatments that may be available in the future.