In up to 50% of all penetrating keratoplasty procedures, the indication for surgery is endothelial decompensation. In the absence of stromal opacities or high-degree astigmatism, new endothelial cells are all that is required. For this reason Descemet’s Stripping Automated Endothelial Keratoplasty was developed in the recent years and has gained widespread popularity. With this procedure, the recipient cornea is maintained, with exception of the Descemet membrane and endothelium complex which are removed from the central part (usually 9.0 mm in diameter) of the posterior corneal surface. The donor graft consists of a thin lamella (usually 100-200 µm thickness) of deep stroma carrying the donor Descemet membrane and endothelium.