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Pre-Descemet's endothelial keratoplasty (PDEK)
  1. Amar Agarwal1,
  2. Harminder S Dua2,
  3. Priya Narang3,
  4. Dhivya A Kumar1,
  5. Ashvin Agarwal1,
  6. Soosan Jacob1,
  7. Athiya Agarwal1,
  8. Ankur Gupta2
  1. 1Dr. Agarwal's Eye Hospital and Eye Research Centre, Chennai, India
  2. 2Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
  3. 3Narang Eye Care & Laser Centre, Ahmedabad, Gujarat, India
  1. Correspondence to Dr Amar Agarwal, Dr. Agarwal's Eye Hospital and Eye Research Centre, 19, Cathedral Road, Chennai 600 086, India; dragarwal{at}


A new surgical technique for endothelial keratoplasty is described, in which the composite of pre-Descemet's layer (Dua's layer) with Descemet's membrane and endothelium is transplanted subsequent to the removal of the recipient's Descemet's membrane. The technique was performed in five eyes of five patients, with successful attachment of the graft and good postoperative visual recovery in all cases. Postoperative optical coherence tomography showed good graft attachment without interface abnormalities and a mean graft thickness was 28±5.6 μm. This study demonstrates the practicality of the technique, termed pre-Descemet's endothelial keratoplasty (PDEK), which can be a viable option in endothelial keratoplasty with some potential advantages.

  • Cornea
  • Treatment Surgery

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