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This multicentre randomized trial compared ultrathin DSAEK with conventional DSAEK in patients undergoing endothelial keratoplasty for Fuchs endothelial dystrophy. The aim was to determine whether using a thinner donor graft would improve visual quality without compromising safety or endothelial survival. The study demonstrated that ultrathin grafts are technically feasible and can provide good visual outcomes, supporting the concept that reducing stromal tissue may reduce some of the optical limitations of posterior lamellar grafting. However, graft preparation, handling and postoperative positioning remain important determinants of success. For HCPs, the paper is useful when considering the spectrum between DSAEK and DMEK. Ultrathin DSAEK can be an attractive option when the surgeon wants the relative handling advantages of DSAEK while moving toward a thinner graft profile. AIOC's lamellar corneal surgery sessions make this evidence particularly relevant for surgeons refining endothelial keratoplasty technique.

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This multicentre randomized trial compared ultrathin DSAEK with conventional DSAEK in patients undergoing endothelial keratoplasty for Fuchs endothelial dystrophy. The aim was to determine whether using a thinner donor graft would improve visual quality without compromising safety or endothelial survival. The study demonstrated that ultrathin grafts are technically feasible and can provide good visual outcomes, supporting the concept that reducing stromal tissue may reduce some of the optical limitations of posterior lamellar grafting. However, graft preparation, handling and postoperative positioning remain important determinants of success. For HCPs, the paper is useful when considering the spectrum between DSAEK and DMEK. Ultrathin DSAEK can be an attractive option when the surgeon wants the relative handling advantages of DSAEK while moving toward a thinner graft profile. AIOC's lamellar corneal surgery sessions make this evidence particularly relevant for surgeons refining endothelial keratoplasty technique.
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