Jithmi Weliwitage

To the editor Patients with hematological malignancies undergoing allogeneic hematopoietic stem-cell transplantation (allo-HSCT) face a (procedural) mortality of about 50% against the background of a real chance of cure [1]. Therefore, timely attention to end-of-life issues during the transplant trajectory is essential in cases of an unfavorable disease course, to prevent detrimental aggressive therapies at the end of life [2, 3].

1 INTRODUCTION Penetrating keratoplasty (PK), first performed in 1905 (Dick et al., 2025; Zirm, 1989), was for a long time the method of choice for repeat PK in cases of graft failure. A common cause of graft failure after PK is endothelial decompensation (Hos et al., 2017). In such cases, if the corneal stroma shows no opacities beyond oedema and the patient was satisfied with the graft function prior to decompensation, endothelial keratoplasty can now be considered a standard treatment option.

Introduction Descemet membrane endothelial keratoplasty (DMEK) is becoming the gold standard for endothelial keratoplasty worldwide. One key step in performing DMEK is the preparation of the 10 to 15-µm-thick Descemet membrane (DM)/endothelial donor lamella. There is mounting evidence that graft preparation properties correlate with donor characteristics.