Dr. Terry Kim presents evidence on why Descemet's stripping automated endothelial keratoplasty (DSAEK) should be the preferred EK procedure. He discusses 7 important categories:

• Trends: The overwhelming majority of EK surgeries between 2012 and 2015 were DSAEK, DSEK, or DLEK.
• Visual results: Investigations have shown high rates of good visual acuity after 3 years.
• Endothelial cell loss: 1-year loss was comparable with that of DMEK, according to multiple studies.
• Donor tissue issues: DSAEK donor tissues have no age restriction, and because they are precut, they are of known quality and thickness and come with orientation markings.
• Surgical technique: Straightforward and simplified procedure compared with DMEK; flexible to different approaches
• Comorbidities and complex cases: DSEAK works well in patients with corneal issues that affect visualization, with past glaucoma surgeries, with aphakia, and with iris issues.
• Complications: Short learning curve, low rate of complications and graft failure