Endothelial keratoplasty in integrity-damaged iridolenticular diaphragm

The review presents methods for performing endothelial keratoplasty (EK) in patients with endothelial corneal dysfunction, combined with discontinuities of the iridolenticular diaphragm as reflected in the PubMed, Scopus and eLibrary reference databases for the period ending in 2022. EK performed according to a variety of techniques allows achieving good clinical and functional results and reducing the risk of complications at different stages of treatment of patients with endothelial insufficiency. Another important advantage of EK as compared to penetrating keratoplasty is the fact that it can be repeated multiple times, which is relevant for patients with severe combined pathologies. Considering the plethora of modifications of posterior lamellar keratoplasty and transplantation of the Descemet's membrane and endothelium for cases with combined damages of the integrity of the iridolenticular diaphragm, the number of affected patients may be even more numerous than presented in the publications reviewed. The variety of literature data shows that the search for a universal technique of EK to be performed on patients with various disorders of the iridolenticular diaphragm is likely to continue.