DMEK (Descemet Membrane Endothelial Keratoplasty): This is an outpatient surgery in which only the innermost layer of the cornea (endothelium) is replaced while preserving the outer layers, using a donor graft. It is indicated when the only affected layer is the endothelium, such as in the case of decompensated guttate corneas or corneal decompensation following cataract surgery (bullous keratopathy). By selectively transplanting a single layer, it allows for rapid recovery of visual acuity and minimizes the risk of corneal rejection.
DSAEK (Automated Endothelial Keratoplasty): This is also performed on an outpatient basis, transplanting the two posterior layers of the cornea (Descemet’s membrane and endothelium). It is currently performed secondarily when DMEK is contraindicated due to abnormalities in the anterior chamber of the eye (the space between the cornea and the lens).
