Researchers retrospectively reviewed the histopathology of full-thickness corneas from 10 penetrating keratoplasty patients who had previously undergone Descemet stripping with endothelial keratoplasty (DSEK). DSEK graft adhesion was not associated with significant scarring or keratocyte proliferation. Residual host Descemet membrane was found in 8 cases but did not appear to hinder graft adhesion, raising the possibility that Descemet membrane removal may be unnecessary for endothelial transplantation. American Journal of Ophthalmology, August 2009.