Eventual Endothelial Failure After Initial Corneal Clearing After a Detached Endothelial Graft in Fuchs Dystrophy

mated Bowman layer preparation with a 90to 100-mm-thick donor lamella of anterior stroma (instead of an 8to 12-mm-thick isolated Bowman layer graft). In our experience, the presence of donor stroma seems to degrade the optical quality of the transplanted cornea (as Descemet stripping endothelial keratoplasty/Descemet stripping automated endothelial keratoplasty grafts containing donor stroma may perform less well than isolated Descemet membrane endothelial keratoplasty grafts or deep anterior lamellar keratoplasty with retained recipient posterior stroma as compared with deep anterior lamellar keratoplasty with bare recipient Descemet membrane).1,9–12 For that reason, we purposely developed a technique to manually prepare isolated Bowman layer grafts, that is, grafts with the least possible donor stroma attached,10 to obtain the highest visual outcome in this young, and therefore relatively active, patient group.