Corneal Transplant
Surgery

Descemet's Membrane Endothelial Keratoplasty (DMEK) is an advanced corneal transplant procedure designed to treat corneal endothelial diseases such as Fuchs' Dystrophy and bullous keratopathy. Unlike traditional corneal transplants, DMEK is a partial-thickness transplant that replaces only the damaged endothelial layer with donor tissue while preserving the patient's natural corneal structure. This often results in faster visual recovery, better visual outcomes, and a lower risk of rejection compared to procedures such as DSAEK.

DMEK offers several benefits that make it the preferred option for many patients with endothelial dysfunction. Patients often experience sharper vision, lower rejection rates, faster healing, and less induced astigmatism after surgery. Because only the diseased endothelial layer is replaced, patients generally require lower doses of steroid eye drops, helping reduce the risk of steroid-related complications.

While DMEK is highly effective, there are some potential drawbacks to consider. The procedure requires advanced surgical expertise due to the delicate nature of the donor tissue. In some cases, the transplanted endothelial layer may partially detach and require repositioning with an additional air or gas injection. Some patients may also experience temporary vision fluctuations during healing. Patients with significant corneal scarring or previous glaucoma surgery may not be ideal candidates.

DMEK is performed on an outpatient basis using local anesthesia and mild sedation. During surgery, the damaged endothelial layer is carefully removed while preserving the remaining healthy corneal tissue. A thin layer of donor endothelial cells and Descemet's membrane is then inserted into the eye.

An air bubble is used to position the donor tissue against the patient's cornea, allowing it to naturally adhere during healing. Patients are often instructed to remain face-up for several hours after surgery to promote proper graft attachment. The procedure typically takes between 30 and 45 minutes per eye.

Following surgery, patients are prescribed antibiotic and anti-inflammatory eye drops to support healing and reduce the risk of infection. Regular follow-up visits are scheduled to monitor graft attachment and overall recovery.

Many patients notice significant improvement in vision within a few days, with continued improvement over the following weeks and months. Patients should avoid strenuous exercise, swimming, and rubbing their eyes for at least two weeks after surgery.

DMEK can be very successful. Patients often experience improved contrast sensitivity, sharper vision, and enhanced corneal clarity.

Because DMEK replaces only the diseased endothelial layer, the overall transparency and health of the cornea are preserved. The procedure also has one of the lowest rejection rates among corneal transplant surgeries and provides excellent long-term stability once healing is complete.