Dr. Mark Terry gives his insights into the successful posterior lamellar translplantation procedure in an interview with Dr. Clark Springs. Dr. Terry describes why his group has the lowest endothelial graft dislocation rate and the lowest primary graft falure rate - the technique. A 5mm scleral-tunnel (vs. clear corneal) incision is done to enable the preservation of the endothelium - smaller confers no advantage. Long term follow-up at 8 yrs has shown that the grafts are clear but the endothelial cell counts have decreased to about 500 by 5 yrs, where it plateaues. No anterior chamber maintainer is needed. Fill the chamber with Healon 5, a visco-cohesive, until you implant the tissue. Healon does not contribute to dislocation. It does not appear in the interface. Proper tissue folding can obviate the need for marking the donor tissue - no need for an "S" mark. Graft diameter is matched to 8.5. Start at 8.0 of you're new to the technique. 40/60 fold and then inserted 60/40". - technique paper in press. Don't worry about chamber collapse. Use self sealing bevelled pericentisis sites vs. a 30 gauge needle. DSEK, DSAEK is compared to DLEK (stripping vs. dissection) physics of adhesion. Dr. Terry then discusses future trends in DSEK instrumentation such as inserters and the evolution of the DMEK procedure.