Current concepts and recent trends in endothelial keratoplasty

Table 2 Summary of comparative and non-comparative studies reporting the outcomes of corneal endothelial transplant procedures in various clinical scenarios

Ref.	Publication	Study design	Study duration	Study participants	Survival outcomes
Fu et al[43], 2024	Cornea	Retrospective clinical cohort study	10 years	356 (DSEK), Indication: 209 (FECD), 88 (bullous keratopathy), 39 (previous graft failure)	Overall, DSEK has a 79% 10-year graft survival rate (including complex grafts), with higher rates for Fuchs endothelial dystrophy (92%), despite significant endothelial cell loss
Woo et al[53], 2019	American Journal of Ophthalmology – Glaucoma	Retrospective comparative cohort study	27 years	121 eyes (DMEK), 423 eyes (DSAEK), 405 eyes (PK), for a total of 949 eyes from patients with FECD, and BK	DMEK (97.4%) has better long-term graft survival and lower complication rates compared to DSAEK (78.4%) and PK (54.6%)
Price et al[54], 2011	Ophthalmology (Rochester, Minn.)	Retrospective interventional case series	5 years	165 eyes (147) (89%)-FECD and 18 eyes (11%)-PBK and ABK]	Five-year graft survival and endothelial cell loss after Descemet's stripping endothelial keratoplasty are comparable to penetrating keratoplasty
Birbal et al[55], 2020	Cornea	Retrospective interventional case series	5 years	500 eyes of 393 patients. Indications: FECD, Bullous keratopathy, failed grafts	5 Five-year graft survival probability in 0.90 with 82% achieving > 20/25
Deng et al[56], 2018	Ophthalmology (Rochester, Minn.)	Systematic review	Follow-up ranged from 5.7 to 68 months		DMEK is a safe and effective treatment for corneal endothelial dysfunction, with better visual outcomes and lower refractive error compared to DSEK
Kang et al[57], 2019	Journal of Glaucoma	Retrospective case series	Mean follow-up of 36.5 ± 31.4 months	83 patients who underwent 122 DSEK procedures on 85 eyes	DSEK after glaucoma drainage device implantation has high graft failure rates and adverse effects on long-term graft survival
Baydoun et al[58], 2015	JAMA Ophthalmology	Retrospective cross-sectional studies	Approximately 9 years, from August 8, 2006 to June 17, 2015, with endothelial survival followed for up to 8 years after the DMEK procedures	352 eyes, with 314 -FECD, 31 eyes-bullous keratopathy, and 7 eyes -failed previous endothelial grafts	Endothelial survival after Descemet membrane endothelial keratoplasty is better in eyes with Fuchs endothelial corneal dystrophy and completely attached grafts compared to eyes with bullous keratopathy and partially detached grafts

DMEK: Descemet membrane endothelial keratoplasty; DSAEK: Descemet stripping automated endothelial keratoplasty; PBK: Pseudophakic bullous keratopathy; ABK: Aphakic bullous keratopathy; FECD: Fuch’s endothelial corneal dystrophy.