Understanding DMEK (Descemet Membrane Endothelial Keratoplasty) Surgery

Corneal transplants are the most common type of tissue transplant in the United States. Medical advancements and the experience of dedicated surgeons like David Fuerst, MD and Nicole Fuerst, MD make cornea transplantation more routine than ever. If you need corneal surgery to help you see, then you want the experienced providers at Fuerst Eye Center to see you through.

What is DMEK corneal transplantation?

DMEK is the most advanced form of partial corneal transplant procedure indicated in diseases affecting the innermost, endothelial layer of the cornea. In DMEK surgery, only a single thin layer of cells is replaced, allowing for an exact anatomical replacement of the damaged cells. This technique allows for decreased rates of rejection and faster visual recovery.

What conditions can be treated with DMEK?

DMEK is best suited for diseases that cause corneal swelling by affecting the innermost layer of the cornea such as:

• Fuchs’ endothelial dystrophy
• Posterior polymorphous membrane dystrophy
• Congenital hereditary endothelial dystrophy
• Bullous keratopathy
• Iridocorneal endothelial (ICE) syndrome
• Failed previous corneal transplants

How is the recovery after DMEK surgery?

For the first few days after surgery, you will be instructed to lay flat on your back to help the graft attach to your cornea. Our doctors recommend lying flat for 45 minutes out of every hour for the first few days after surgery. Eye drops are used for several weeks to help prevent infection and control inflammation. You will use a steroid eye drop (once daily) to prevent rejection of the transplant for a long time. Post-operative examinations are usually scheduled within 1 day, at 1 week, at 1 month and at 3 months. It is important to not rub or bump the eye and to use protective eyewear when engaged in any activity which may cause eye injury. You will sleep with an eye shield for 3 nights. Swimming or diving underwater should be avoided for two weeks. Visual recovery usually takes a couple of weeks.

What are the risks of DMEK surgery?

DMEK surgery is highly successful. If the graft is not fully attached, a small in-office procedure may be needed to place an additional air bubble in the eye. Significant, sight-threatening complications are exceedingly rare. These include intraocular infection (endophthalmitis), retinal detachment, corneal edema (swelling), retinal edema (swelling), and hemorrhage. Additional surgery may be necessary if the corneal swelling never clears. Abnormalities of pupil size, shape, or function may rarely result from corneal surgery.

What does corneal surgery cost?

Medicare and private insurance companies cover corneal surgery.

Why Fuerst Eye Center?

Dr. David Fuerst and Dr. Nicole Fuerst are fellowship-trained corneal specialists who have extensive experience performing corneal surgery. Our ophthalmologists can detect exactly which layers of the cornea are affected, whether it’s the outer layer, inner layers, or the entire cornea. They then utilize the latest diagnostic and treatment technology to optimize surgical outcomes, using the most advanced transplant techniques to create a customized treatment for you.

If you have corneal disease, schedule an appointment with our doctors in Glendale or West Covina, California today. Please contact our office with any questions.