DMEK is a modern corneal transplant that replaces only the damaged endothelial layer at the back of the cornea. It is commonly used for conditions like Fuchs endothelial dystrophy.
How the surgery is performed
The surgeon removes the patient’s diseased endothelium through a small incision. A very thin donor graft containing Descemet membrane and healthy endothelial cells is then inserted and unfolded.
- An air or gas bubble presses the graft against the back of the cornea
- Patients often lie on their back for several hours to help it stick
- The incision is small and may need few or no stitches
- Topical drops are used afterwards to prevent rejection and infection
Benefits and considerations
DMEK offers excellent visual potential and low rejection rates. However, it is technically demanding and not suitable for every eye.
- Vision often improves within weeks once swelling clears
- Detachments can occur and sometimes need rebubbling
- Some complex corneas may require other transplant types
- Regular follow-up checks pressure, clarity, and graft health
