DMEK – Partial Thickness Transplant Technology
Descemet Membrane Endothelial Keratoplasty or DMEK is a ultra thin partial thickness corneal transplant which was first described in 2006 but widely adopted in just the last few years. It is the latest iteration of partial thickness corneal transplant technology. Compared to DSEK, DMEK is a more technically challenging procedure for the surgeon but provides greater benefits to the patient. It is currently being adopted by corneal surgeons across the world after it has proven to be superior to other forms of partial thickness transplant technology.
DMEK is indicated for patients with corneal edema after cataract surgery or Fuchs endothelial dystrophy, and otherwise healthy eyes with good visual potential. Patients with other eye diseases such as macular degeneration or glaucoma are better candidates for DSEK. The deteriorated endothelial cells are removed from the patient’s eye along with the Descemet’s membrane. An ultra thin corneal transplant from a donor consisting of a single layer of cells and Descemet’s membrane only is inserted into the eye, and the patient keeps most of the outer layers of their own cornea. The transplanted layer of cells is pressed against the patient’s own cornea with an SF6 gas bubble injected into the eye. The patient must lay flat on their back as much as possible until the SF6 gas bubble is absorbed after approximately 1 week. The patient’s should not fly for approximately 2 weeks after the surgery. Some patients may require a second SF6 gas bubble to be injected in the eye in the office or in the operating room to help with adhesion. The final visual acuity is usually better than any other form of corneal transplantation, including DSEK. It is thought that DMEK transplants have the lowest rates of rejection compared to DSEK and PKP, but patients must still remain on steroid eye drops for a few years after surgery.