DEC 09, 2016
In this interview from AAO 2016, Dr. Amar Agarwal discusses the benefits of a pre-Descemet’s endothelial keratoplasty (PDEK) over Descemet stripping automated endothelial keratoplasty (DSAEK)and Descemet membrane endothelial keratoplasty (DMEK). Dr. Agarwal, who co-developed the technique in 2013, says the addition of the distinct pre-Descemet’s layer in a PDEK graft creates a buffering tissue layer that reduces scrolling and risk of tearing, making both harvesting and manipulation during implantation easier. However, the graft is still thin enough (25 microns) to prevent the added stress on the endothelium to pump fluid from the cornea that is associated with DSAEK. Physicians may maintain the same preferred injection technique they use for DMEK, but unfolding is much simpler thanks to a simple continuous air pump under the graft. Furthermore, graft availability is significantly expanded in PDEK, as donors can be as young as 9 months old, compared to the requirement of at least 40 years old for a DMEK donor.
View Dr. Agarwal's video: 15 Steps to Mastering PDEK