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The article discusses refractive surgery controversies. Topics discussed include keratoconus as a definitive contraindication for refractive surgery due to instability of the cornea's structural bonds, lower amount of preoperative corneal thickness that is directly related to the presence of low residual stromal bed (RSB) thickness and higher degree of myopia related to residual stromal bed thickness.

The article discusses the experiences of surgeons performing a Descemet's membrane endothelial keratoplasty, (DMEK) and if it should be considered as an effective option for corneal transplant. Topics included are enhanced visual activity of patients post surgery, stroma for inducing immune rejection and Australian Graft Registry stating penetrating keratoplasty is better than DMEK and Descemet's stripping endothelial keratoplasty (DSEK). Also included are comments by surgeon Mark A. Terry. INSET: The Australian Graft Registry: Is PK Better?.

The article focuses on the latest technology in keratoplasty called Descemet's membrane endothelial keratoplasty (DMEK). Topics include the dissection of the posterior corneal stroma, advantages of DMEK which include rapid recovery of vision and less risk of immunologic rejection and disadvantages of DMEK which includes a risk of graft dislocation, and use of sulfur hexafluoride.