DMEK - General Information //
Disease or trauma to the cornea can affect the clarity of the cornea, adversely affect the shape and thus the focusing ability of the cornea, or affect the structural integrity of the eye. In some of these circumstances, the best treatment option will be the surgical replacement of the cornea with a donated cornea. This is called a cornea transplant.
DMEK is a partial-thickness type of cornea transplant primarily used when there is swelling of the cornea. This is an outpatient surgery that is performed in an operating room under a specialized surgical microscope. In most cases a local anesthetic agent is given around the eye in combination with intravenous sedation and this generally provides effective anesthesia. Surgery usually takes 45-75 minutes, but can take longer depending on any additional procedures that may be performed.
In DMEK, the unhealthy corneal endothelium is stripped out through a small incision at the edge of the cornea. Like DSAEK, a thin, partial thickness donor cornea is then placed into the eye, positioned and held in place with a large air bubble. The donor graft in DMEK extremely thin, potentially allowing for an improved visual outcome with a faster recovery. Your doctor can discuss the pros and cons of the various cornea transplant options for your condition. The patient will be asked to spend the first few postoperative days lying flat on their back to give the graft the best chance to attach properly.
Surgical complications can occur with any procedure, including DMEK. Unfortunately, in about 5% of cases, the corneal graft may not attach properly. When this occurs, a minor procedure can usually be performed to reattach the graft successfully. As with any form of corneal transplantation, a possibility of graft rejection exists with DMEK. When this occurs, the patient may have redness, light sensitivity and/or blurred vision, and the corneal tissue may become swollen and loose its clarity. In most cases, early initiation of aggressive steroid treatment can reverse these changes. There is evidence that suggests that the rejection rate is lower with DMEK than with other forms of corneal transplantation.
Following DMEK, the visual recovery will generally require several weeks to several months. Eye drops will be utilized on a daily basis to prevent infection and rejection. Good compliance with the treatment regimen and with follow-up visits is critical for successful DMEK.
Each patient's eye is different. The descriptions above may not apply to every individual situation. Your doctor at Michigan Cornea Consultants will perform a full evaluation and discuss their findings and recommendations thoroughly with you. A treatment regimen will be planned and re-evaluated throughout your follow-up visits. Please also see the documents in the Forms section below for more information.
Surgical Forms //
Once you have had your consultation and have been deemed a candidate for a DMEK, below are the surgical forms for you to read and complete. Please use the pre-op checklist form (see below) to ensure you have read and completed the necessary forms. For any questions, please contact Elly, the surgical coordinator at 248-350-1130, extension 304
Read, Print, Complete and Return