DMEK (Descemet membrane endothelial keratoplasty) is the most recent corneal endothelial transplatation technique. The transplant has a thickness of about 10 micrometers. The technique is surgically challenging as the endothelial cell are located on the outside of the transplant and are not to be touched as this causes damage and can lead to failure of the transplant. The diseased endothelial layer is excised and the prepared transplant is inserted into the eye by a shooter. In the anterior chamber, the transplant must be unrolled, centered and orientated correctly. If this is achieved, the transplant is pressed against the cornea with the help of an air or gas bubble for one hour. After his time, the air/gas can be partially removed. In most cases, no stitches are needed. This procedure is ideal for “uncomplicated” eyes, that did not have specific surgeries before (eg. glaucoma device surgery). Improvement of vision can be achieved within weeks of the procedure. The advantages are that the previous anatomy is being restored, improving vision more than with other techniques, and rejection rate is lower than in other endothelial procedures.

More information (german only) can be found here

Click here for a video of a DMEK surgery