Corneal endothelial dysfunction may be inherited e.g. Fuchs�� endothelial dystrophy, or acquired due to surgical trauma e.g. pseudophakic bullous keratopathy. These are the leading causes of corneal transplantation in most developed countries. The field of corneal transplantation has evolved rapidly in the past 10 years. Full-thickness penetrating keratoplasty techniques have been replaced by newer partial-thickness techniques for many corneal diseases. In ICG-001 particular, endothelial keratoplasty techniques like Descemet��s stripping endothelial keratoplasty and Descemet��s membrane endothelial keratoplasty have been very successful for treating endothelial disease. Since 2005, the number of PK procedures performed in the USA has steadily dropped, while EK procedures have consistently risen, so much so that EK became the dominant procedure in 2012. DSEK involves transplanting a posterior lamellar corneal graft, consisting of donor corneal endothelium, Descemet��s membrane, and a layer of posterior stroma, to replace dysfunctional recipient corneal endothelium. DSEK provides faster visual recovery, greater tectonic stability, less induced astigmatism, and lower rates of immunologic rejection, with comparable 3-year graft survival and endothelial cell loss rates to PK. DSEK has also been shown to be more cost-effective than PK. Furthermore, DSEK grafts can be precut prior to surgery, which simplifies the procedure and reduces operating time. However, EK, like any transplant procedure, is reliant on the availability of donor tissue. Stricter tissue testing regulations and precautions against transmission of infectious SCH772984 clinical trial disease have led to more costly processing and higher tissue discard rates, which both contribute to the rising cost of donor corneal tissue from eye banks. With aging populations and higher incidence of age-related corneal disease, the demand for donor tissue is also likely to increase. Meanwhile, supply of donor tissue is unlikely to keep up, as most eye banks do not retrieve corneal tissue from donors above 75 years of age. Stricter age criteria on donor tissue imposed by surgeons could dramatically worsen this situation further.