[Descemetorhexis and corneal clearing: a new perspective on the treatment of endothelial diseases].

The corneal endothelium, made up of a uniform monolayer of polygonal cells having a width of approximately 20 , is a fundamental structure for maintaining corneal transparency by means of active transport of water in the reverse direction to avoid corneal edematization.1 Primary endothelial disorders such as Fuchs’ endothelial dystrophy or acquired lesions such as those secondary to surgical trauma produce alterations in this layer with ensuing (and most frequently irreversible) visual loss. Loss or severe damage of these cells has been considered irreparable up to now as the endothelium does not regenerate in case of injury. In addition there is no possibility for mitosis and damaged cells are substituted by hypertrophy of adjacent cells and collagen, without the capacity for actively carrying water.1 However, in the last decade the above theory has been questioned because doubts are being cast on what in the past was considered to be irreparable. Endothelial dystrophy is fatal for maintaining said endothelial transparency and, until very recently, it was deemed that incision and complete loss of the Descemet-endothelium complex in a