DMEK / DSEK

Descemet’s membrane endothelial keratoplasty, also known as DMEK, is an advancement in the field of corneal transplant surgery. During a DMEK procedure, only the innermost layers of the cornea are replaced, instead of the whole thickness of the cornea. This technique is much less invasive than a traditional penetrating keratoplasty, which requires replacement of the full cornea and is one of several selective corneal transplant procedures now commonly performed.

Reasons for DMEK

DMEK is often performed to improve vision that has been compromised by Fuch’s’ dystrophy, an inherited eye disease that affects eyesight and may cause pain or sensitivity in the eyes, or to treat bullous keratopathy, a persistent corneal swelling that affects vision.

The DMEK Procedure

After the patient’s damaged tissue is removed from the cornea, the donor replacement tissue is carefully placed at the rear of the cornea. Few or no sutures are needed. The DMEK procedure takes only half as long as a penetrating keratoplasty.

Since only inner layers of the cornea are replaced in a DMEK procedure, patients typically recover much more quickly than patients who have undergone a more traditional corneal transplant. Most DMEK patients achieve improved visual acuity within 1week after the surgery and very few suffer complications.

Advantages of DSEK

The DSEK procedure, which transplants only the posterior portion of the cornea, has many advantages over more penetrating surgeries. These include:

  • Greater safety
  • Shorter procedure
  • Only two small incisions
  • Fewer or no sutures
  • Less trauma to the eye
  • Less likelihood of graft dislocation
  • Stronger cornea after surgery
  • More predictable vision results
  • Better ocular balance

The recovery from a DSEK procedure is much quicker than the recovery from a traditional corneal transplant. Where the latter can take a year, or even two, DSEK patients may be fully recovered in 3 to 6 months.

Risks of DSEK

The visions results of DSEK are good, but there is increased risk that the corneal graft, which is extremely thin, will not attach properly and may be rejected.