Descemet Endothelial Thickness Comparison Trial II

Open to people ages 18 years and up

• Dysfunctional endothelium from FECD with few guttata extending beyond 4.5 mm
• Peripheral endothelial cell count >1500 cells/mm2
• Good surgical candidate for either procedure as determined by the surgeon
• Willingness and ability to undergo corneal transplantation
• Willingness to consistently use study medications (i.e. ROCK-inhibitors)
• Willingness to participate in follow-up visits
• Age greater than 18 years

• Other primary endothelial dysfunction such as PPMD
• Any prior intraocular surgery other than cataract surgery
• Cataract surgery within the last 3 months
• >3 clock hours of ANY anterior or posterior synechiae
• >1 quadrant of stromal corneal vascularization
• Visually significant optic nerve or macular pathology
• Fellow eye visual acuity <20/200
• Pregnancy
• Inability to comply with post-operative instructions (i.e. unable to position)
• Hypotony (Intraocular pressure <10mmHg)
• Peripheral anterior synechiae (iris to angle) in the angle greater than a total of three clock hours
• Aphakia, anterior chamber IOL or scleral fixated IOL in study eye prior to or anticipated during EK
• Pre-operative central sub-epithelial or stromal scarring that the investigator believes is visually significant and could impact post-operative stromal clarity assessment