title: [Update Minimally Invasive Lamellar Keratoplasty: DMEK, DSAEK and DALK].
abstract: BACKGROUND
  The spectrum of operative interventions in corneal disorders requiring keratoplasty has been expanded considerably in recent years. In addition to the standard technique with full-thickness replacement of the cornea (perforating keratoplasty), lamellar techniques have been introduced. The aim of this review is to highlight current opportunities, indications and complications, as well as possible strategies to standardise lamellar keratoplasties.
  
  
  METHODS
  Our own data and a review of the literature in PubMed are summarised.
  
  
  RESULTS
  Performing "Descemet Membrane Endothelial Keratoplasty" (DMEK), "Descemt Stripping Automated Endothelial Keratoplasty" (DSAEK) and "Deep Anterior Lamellar Keratoplasty" (DALK) can provide patients with disorders of the corneal endothelium or the anterior corneal stroma with minimally invasive corneal grafts at a reduced risk of complications.
  
  
  CONCLUSIONS
  DMEK and DSAEK are now internationally the surgical methods of choice in patients with endothelial corneal pathologies, i.e. in Fuchs' Endothelial Dystrophy. The DALK technique for lamellar replacement of the anterior stroma, i.e. in keratoconus, needs further standardisation, so that DALK can in future be performed more often even in less specialised departments. Major advantages of lamellar keratoplasties are the very good results in visual outcome and fewer immune reactions or graft rejections. Even intraoperative complications are rare. In the long term, further strategies are desirable for the standardisation of lamellar keratoplasties and its establishment as the primary standard procedure.
authors.affiliation: Zentrum für Augenheilkunde, Universitätsklinikum Köln.
authors.forename: C
authors.initials: C
authors.lastname: Cursiefen
authors.affiliation: Zentrum für Augenheilkunde, Universitätsklinikum Köln.
authors.forename: F
authors.initials: F
authors.lastname: Schaub
authors.affiliation: Zentrum für Augenheilkunde, Universitätsklinikum Köln.
authors.forename: B O
authors.initials: BO
authors.lastname: Bachmann
mesh_terms: D003316:Corneal Diseases / Q000175:diagnosis / Q000601:surgery*; D003886:Descemet Membrane / Q000601:surgery*; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome