Partial Thickness Corneal Transplants: DSAEK & DMEK Options

When a full-thickness corneal transplant isn’t required, your surgeon may recommend a partial-thickness procedure—also known as endothelial keratoplasty—to replace only the damaged layers of your cornea. By preserving your healthy tissue and swapping in donor grafts for the diseased layers, we restore clarity while maintaining corneal strength and shape.

Why Choose a Partial-Thickness Transplant?

Not every corneal disorder requires a full-thickness graft. Partial-thickness procedures like DSAEK and DMEK target only the damaged inner layers, Descemet’s membrane, and endothelium while preserving your healthy outer tissue. That means:

Faster Visual Recovery: Most patients notice significant clearing within weeks rather than months.
Stronger Corneal Integrity: Retaining more of your native cornea reduces healing time and lowers complication rates.
Lower Rejection Risk: Smaller, thinner grafts promote better integration and fewer immune reactions.

Surgeons typically recommend partial-thickness keratoplasty for conditions such as Fuchs’ dystrophy, endothelial dysfunction after prior surgery or injury, and other diseases confined to the deepest corneal layers. If you’re looking for a quicker path back to clear vision, these advanced techniques could be the right choice for you.

Endothelial Keratoplasty (DSAEK)

When It’s Used: Descemet’s-stripping automated endothelial keratoplasty (DSAEK) treats vision loss caused by endothelial dysfunction—whether from prior surgery, inflammation, injury, or inherited conditions like Fuchs’ dystrophy.
Procedure Overview: Performed as an outpatient under local anesthesia (with optional sedation), DSAEK replaces only Descemet’s membrane and endothelium (plus a thin sliver of stroma) via a small corneal incision. A donor graft, prepared by a precision microkeratome, is positioned beneath your native tissue and held in place with an air or gas bubble—no permanent sutures needed. If the graft doesn’t adhere fully, a quick “re-bubble” can secure it within weeks.
Recovery Benefits: Patients heal faster than with full-thickness transplants. Although the graft looks cloudy initially, vision typically clears within 1–2 months, and glasses fitting follows in 4–6 months (versus 12–18 months for full-thickness). Because only the deepest corneal layers are replaced, overall corneal integrity remains stronger.

Descemet’s Membrane Endothelial Keratoplasty (DMEK)

When It’s Used: DMEK offers an even gentler approach by replacing only Descemet’s membrane and endothelium—with no extra stroma—making it the least invasive partial transplant.
Procedure Overview: Like DSAEK, DMEK is outpatient, uses local anesthesia, and relies on an air/gas bubble to secure a meticulously prepared donor graft. If needed, a re-bubble can re-seat the tissue within the first few weeks.
Recovery Benefits: Vision improves more rapidly—often within 1–2 weeks—and patients may wear glasses as soon as 1–2 months after surgery. Because DMEK uses the thinnest possible graft, the risk of rejection falls and the chance of achieving 20/20 vision rises.

Potential Risks

As with all surgeries, endothelial keratoplasty carries certain risks. Graft rejection is rare but possible; if it occurs, a repeat transplant, partial or full, can often restore vision. Other complications include transient graft detachment (managed by re-bubbling) and mild incision-related discomfort. Your surgeon will review all risks and tailor the procedure to your eye’s needs.

Find Relief Today

If corneal disease or injury interferes with your daily life, a partial-thickness transplant may offer faster recovery and outstanding visual outcomes. Our Arizona surgeons at Barnet Dulaney Perkins are ready to evaluate your condition and guide you toward the most advanced treatment.