Current concepts and recent trends in endothelial keratoplasty

Table 1 Summary of key prospective comparative studies and randomized controlled trials reporting the outcomes of endothelial keratoplasty procedures

Ref.	Publication	n	Study design	Indication	Intervention	Summary
Stuart et al[46], 2016	Cochrane Database of Systematic Reviews	72	Non-randomized, paired, contralateral-eye study	FECD and PBK	DMEK vs DSAEK	DMEK may provide better visual acuity than DSAEK for corneal endothelial failure, but with more graft dislocations
Dunker et al[47], 2020	Ophthalmology (Rochester, Minn)	54	Prospective, multicenter randomized controlled trial	FECD	DMEK vs UT-DSAEK	DMEK and UT-DSAEK corneal endothelial transplantation procedures have similar visual acuity and endothelial cell density outcomes
Dickman et al[48], 2016	Ophthalmology (Rochester, Minn)	66	Multicenter, prospective, double-masked, randomized, controlled clinical trial	FECD	UT-DSAEK vs DMEK	Ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) results in faster and better visual acuity recovery compared to standard DSAEK
Matsou et al[49], 2021	Cornea	56	Prospective, double-blinded randomized controlled clinical trial	FECD	MT-DSAEK vs DMEK	DMEK surgery resulted in significantly better visual acuity compared to MT-DSAEK for treating Fuchs dystrophy-related corneal decompensation
Chamberlain et al[50], 2019	Ophthalmology (Rochester, Minn.)	38	Randomized, controlled, patient- and outcome-masked clinical trial	FECD and PBK	DMEK vs UT-DSAEK	DMEK had superior visual acuity results compared to UT-DSAEK for treating corneal endothelial dysfunction
Shanmugam et al[51], 2023	Cornea	28	Prospective, randomized, interventional study	Corneal Decom-pensation	PDEK vs DMEK	PDEK and DMEK procedures showed comparable visual and graft survival outcomes in endothelial decompensation
Agarwal et al[52], 2017	Canadian Journal of Ophthalmology	6	Prospective, single-centre, interventional case series	PBK	PDEK and DMEK	EK with epithelial debridement performed for the treatment of chronic PBK resulted in significantly improved visual acuity to a functional level, with the clearance of subepithelial fibrosis and anterior stromal scar, in most patients

DMEK: Descemet membrane endothelial keratoplasty; UT-DSAEK: Ultrathin Descemet stripping automated endothelial keratoplasty; DSAEK: Descemet stripping automated endothelial keratoplasty; FECD: Fuchs endothelial corneal dystrophy; PBK: Pseudophakic Bullous Keratopathy; PDEK: Pre-Descemet Endothelial Keratoplasty; MT-DSAEK: Microthin Descemet Stripping Automated endothelial Keratoplasty.