Endothelial keratoplasty is a surgery to replace the disease inner portion of the cornea which can occurs in conditions like Fuchs endothelial dystrophy and pseudophakic bullous keratopathy where there is damage to the endothelium from complicated cataract surgery. The two basic forms of endothelial keratoplasty are DSAEK (descemet stripping automated endothelial keratoplasty) and DMEK (descemet membrane endothelial keratoplasty).
DMEK is a technically more difficult form of surgery but offers the benefit of 1) faster recovery 2) better vision and 3) less risk of rejection of the transplanted tissue. http://www.ophthalmologymanagement.com/articleviewer.aspx?articleID=110223
Due to the technical difficulties of DMEK, very few surgeons in the United States are performing this type of surgery.
DMEK Figure 1. This patient is postoperative day 1 after a DMEK.
A small air bubble is noted which is helping to keep the graft in position.