Corneal transplantation is a widely practiced surgical procedure. Over the past decade, lamellar techniques have been developed to replace penetrating keratoplasty (PK). Endothelial Keratoplasty (EK) has been adapted as an alternative in the treatment of corneal endothelial disorders.In the various forms of endokeratoplasty, Descemet’s membrane and the endothelium are replaced, with or without a varying amount of corneal stroma.
In Descemet’s stripping endothelial keratoplasty (DSEK), the patient’s Descemet membrane is peeled off, using specially designed strippers  and replaced with a partial thickness graft: a transplanted disc of Posterior Stroma, Descemet and Endothelium (10-30 % of the inner donor cornea). Both donor and host cornea are manually dissected. Differently, in Descemet’s stripping automated endothelial keratoplasty (DSAEK) the donor dissection is carried out using a mechanical microkeratome. DSAEK is described as the procedure of choice for corneal endothelial failure in many centers.