The Pros of PDEK
With the supply of corneal tissue continuously decreasing, we should consider approaches that not only make the most of what we’ve got but also expand the donor pool
Priya Narang, Amar Agarwal | | Longer Read
Blindness induced by corneal disease continues to be a huge public health burden, with estimates that it affects around 1.5 million people worldwide (1). Corneal transplantation is an effective treatment option for many patients and has a high success rate in restoring sight, but there’s a catch: the severe shortage of donor corneas means that demand far outstrips supply. And even when donor corneas are available, contamination poses a real risk (2), further reducing the amount of viable tissue available.
Much research has focused on improved methods for early corneal disease diagnosis, as well as on advanced surgical methods that optimize our use of the tissue that we have available to us. With that in mind, one such surgical method, pre-Descemet’s endothelial keratoplasty (PDEK), is effective regardless of donor age (3, 4, 5).
Simply put, the PDEK technique transplants the pre-descemet’s layer (PDL) along with descemet’s membrane (DM) endothelium, which are separated from the residual donor stroma through the formation of a type-1 big bubble (BB). Here we describe the technique, which not only minimizes the use of donor tissue, but it can also be applied using adult and infant donor tissue, too, making it an important one for corneal surgeons to master.
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