Endothelial Keratoplasty (EK) is a revolutionary corneal transplant technique that replaces the damaged inner layer of your cornea, enhancing clarity and improving vision. Our experienced cornea specialists utilize methods like DMEK for optimized results, helping you achieve your best vision possible.
Endothelial Keratoplasty (EK) is a specialized corneal transplant procedure that replaces the diseased inner layer of the cornea with healthy donor tissue. This technique is important because the endothelium is essential for maintaining the clarity of the cornea and, in turn, for good vision. By selectively replacing only the damaged cells, EK offers improved visual outcomes while preserving more of your natural eye structure.
At its core, Endothelial Keratoplasty addresses problems in the innermost layer of the cornea, known as the endothelium. The function of this thin layer is to control fluid balance and keep the cornea clear. When these cells are compromised, fluid accumulates, resulting in corneal swelling (edema) and blurred vision. EK is designed to replace only the affected layer, thereby restoring clarity and significantly improving vision while avoiding many of the complications seen with full-thickness transplants.
This modern procedure is less invasive because it uses a small incision to reach and replace just the damaged layer. Our cornea specialists find that this targeted approach can often lead to faster visual recovery, a reduced need for corrective lenses, and a diminished risk of rejection—especially with the newer techniques available today.
In the world of EK (Endothelial Keratoplasty), Descemet’s membrane is kind of a big deal. It’s the thin, resilient layer inside the cornea that sits right in front of the endothelium—the very cells EK aims to replace.
When diseases like Fuchs’ dystrophy damage the endothelium, Descemet’s membrane often takes a hit too. That’s why EK procedures like DMEK (Descemet Membrane Endothelial Keratoplasty) involve replacing both the damaged endothelium and this membrane in one go.
It may be super thin, but Descemet’s plays a quiet, critical role in keeping the cornea clear—and EK gives it a fresh start.
In this method, the surgeon removes the diseased endothelium along with a small portion of the posterior stroma (a part of the cornea's middle layer). DSAEK is particularly effective in restoring vision with predictable results, though the additional donor stroma may slightly limit the ultimate sharpness of your vision.
This technique is even more refined. It involves transplanting only the damaged endothelium and Descemet’s membrane without any extra stromal tissue. DMEK tends to result in sharper vision and carries a lower risk of rejection, making it a popular choice for many patients.
Both procedures have their place in modern corneal transplantation. The choice of DSAEK or DMEK depends on specific clinical factors, the condition of your eye, and sometimes previous surgeries. Our cornea specialists work closely with each patient to determine which technique will yield the best vision outcomes.
A genetic disorder causing progressive loss of endothelial cells, leading to gradual corneal swelling and vision loss.
Corneal edema, often following cataract surgery or other eye procedures, where the endothelium no longer manages fluid levels effectively.
A rare condition affecting the cornea and iris, leading to abnormal cell growth and reduced vision.
A condition present from birth that compromises the health of the endothelial layer.
In some instances, patients who have had a previous transplant may experience graft failure specifically related to the endothelial cells.
If you have been diagnosed with any of these conditions, EK might be the recommended treatment. By focusing on the damaged inner layer, the procedure avoids the complications associated with full-thickness transplants while offering the benefit of faster recovery and improved vision.
The procedure is performed under local anesthesia, often with numbing eye drops, ensuring your comfort throughout. A small incision is made in the cornea, which greatly reduces healing time and the risk of complications.
The surgeon gently removes the diseased endothelial layer. This selective removal spares much of the healthy corneal tissue, preserving the eye’s natural strength and reducing the risk of complications.
The donor tissue—carefully prepared and, if needed, pre-stained for enhanced visibility—is inserted through the same small incision. Using an air bubble to press the tissue into the correct position, our cornea specialists secure the donor's endothelium against the back of the patient’s cornea.
One of the most crucial steps is ensuring that the new tissue conforms to the corneal curvature. An air bubble is employed to keep the donor tissue in close contact with the cornea while it adheres naturally. In some instances, one or two very fine stitches may be used to close the incision, but this is typically minimal in EK procedures.
Right after surgery, you will be monitored for a couple of hours while the air bubble helps the graft settle in place. Many patients are discharged on the same day.
Expect a series of follow-up appointments: initially within a week, then multiple visits over the first few months to ensure the graft is properly attached and healing is progressing as expected.
You will be prescribed a course of anti-rejection and steroid eye drops, typically for at least six months and sometimes longer. These medications are crucial to minimize inflammation and prevent the body’s immune response from attacking the donor tissue.
Most patients are advised to avoid strenuous activities or actions that increase eye pressure. Lying flat for a few hours after surgery ensures the air bubble remains effective, and our cornea specialists will provide tailored instructions based on your individual recovery.
It’s important to follow your post-operative care instructions closely, as this will support a faster and more stable recovery. If you experience any unusual symptoms, do not hesitate to call our office for personalized guidance.
Don't let corneal issues hold you back any longer. Contact our office today to speak with our cornea specialists about Endothelial Keratoplasty and regain your clear vision. Schedule your personalized consultation now!
Although rare, there is a risk of sight-threatening infection. This risk is minimized by using aseptic techniques during surgery and a strict post-operative regimen.
The body may identify the donor tissue as foreign, leading to a rejection reaction. The rejection rate with DMEK is less than 1% compared to about 6-10% for DSAEK patients in the first two years. Early signs of rejection include redness, eye pain, light sensitivity, and blurred vision. Prompt treatment with anti-rejection medications may reverse these reactions if caught early.
On rare occasions, the new tissue may not function as expected, resulting in clouding and reduced vision. Should this occur, a regraft procedure might be necessary.
It is possible for the implanted donor tissue to shift out of place in about 10-20% of cases, depending on the technique used. This issue is usually corrected with a minor procedure that involves injecting an air or gas bubble to reposition the graft.
As a result of the procedure, some patients might experience a temporary increase in eye pressure. This is typically managed with eye drops and, in rare instances, may require additional surgery.
In a small number of cases, cataracts may develop following EK. These can later be treated with cataract surgery if needed.
Understanding these risks helps set realistic expectations. Rest assured that our cornea specialists take every precaution to reduce these risks and ensure that you receive the best care possible.
One of the major advantages of EK over full-thickness corneal transplants is the significantly faster visual recovery. With traditional procedures, patients might wait months for their vision to stabilize. However, many EK patients notice improvements within weeks, with full stabilization occurring up to three months post-surgery.
Patients who undergo DMEK often experience even sharper vision post-surgery due to the ultra-thin nature of the graft. Studies have shown that almost 75% of DMEK patients achieve visual acuity close to 20/25 or better, which is a remarkable outcome when compared to older methods.
This speed in visual recovery is complemented by the fact that the structural integrity of your cornea is less disrupted during the EK procedure. Fewer stitches and a smaller incision help maintain the natural shape and strength of the cornea, leading to fewer refractive surprises and a reduced need for changing glasses prescriptions over time.
Endothelial Keratoplasty is a modern, minimally invasive solution that offers rapid recovery and excellent visual outcomes. If you are experiencing vision issues such as blurred vision or chronic corneal swelling, please call our office for a personalized consultation. Our cornea specialists are here to guide your treatment and recovery, helping you take the important next step toward clearer vision.
Don't let corneal issues hold you back any longer. Contact our office today to speak with our cornea specialists about Endothelial Keratoplasty and regain your clear vision. Schedule your personalized consultation now!
Endothelial Keratoplasty offers a minimally invasive solution for corneal health. Find a top specialist near you for better vision outcomes.
