Closed eye procedures are preferred by eye surgeons because of increased safety and improved results. Unfortunately, not every eye and not every condition is amenable to the procedure. Open eye or open sky procedures, still result in excellent results in experienced hands.

Closed eye, to eye doctors, is a description of a surgery in which the pressure in the eye is not reduced to zero. In comparison, standard corneal transplantation, even IEK, involves the total removal of a 8.5 millimeter disc of cornea exposing the anterior chamber, iris and lens to the atmosphere. There is no pressure in the eye and the risks of hemorrhage, infection, astigmatism and loss of ocular contents increase. MDALK keeps a formed eye at all times and consequently maintains a normal pressure and dramatically reduces the risks described above.

Routine cataract surgery and even the aquaflow procedure are closed-eye procedure. Pressure is maintained and risk is avoided. It is only recently that any corneal transplants could be performed on a closed-eye system. The DSEK procedure which treats endothelial dystrophy or Fuch’s Dystrophy is also a closed-eye procedure.