Prospective Randomized Study Comparing Endothelial Cell Loss Using the Tan EndoGlide With Forceps for Insertion of the Donor Graft in DSAEK

Inclusion Criteria: * Patients presenting with corneal decompensation requiring DSAEK with or without cataract surgery for visual rehabilitation. * Clinical diagnosis include endothelial cell dysfunction secondary to Fuchs endothelial dystrophy, pseudophakic or aphakic bullous keratopathy, failed penetrating keratoplasty or DSAEK, iridocorneal endothelial syndrome or trauma. * Ability to understand the nature of the procedure and give full informed consent. * Patients who are able to comply with the standard DSAEK follow-up protocol at the Toronto Western Hospital. Exclusion Criteria: * Patients with late stage corneal decompensation with stromal scarring unsuitable for DSAEK and therefore requiring penetrating keratoplasty. * Patients with complex anterior segment pathology precluding successful DSAEK procedure. * Patients not giving full informed consent to participate in the trial