DMEK: the new endothelium corneal transplant

From the USA arrives the new corneal non-invasive transplant, it is a huge innovation in the cure of corneal pathologies because it has a very short recovery time and it seems to remove risks linked with corneal transplant.

The new treatment, called DMEK (Descemet Membrane Endothelial Keratoplasty), is indicated for corneal edema cases, Fuchs’ dystrophy and cornea guttata. This pathologie are very common in Italy and present a familiar condiction: they show up when patients are around 40years of age and year after year the pathology’s gravity increases damaging the cornea even more.

Ten years ago, cornea was entirely transplanted, then only the 30-40% (with DSAEK), now, with this new and more advanced technique, only the 1% of the cornea is transplanted. The result is that the patient is able to see as soon as two weeks after surgery and rejection’s risks are drastically reduced.

In Italy interventions with this pioneristic technic are very few.

Dr. Badalà learned this method in USA and was the first to use it in Milan on 2013.

“DMEK is a futuristica corneal transplant technique because it allows for a transplant of selected damaged corneal cells, while the rest of the eye remains totally intact- explains the surgeon colleague- we are speaking of a tissue that’s about 5 and 10 micron, 100 times less than a millimeter. However this is a complex surgery that asks for advanced instruments, a strong expertise and a great support of the eye bank”.

The great advantage- continues Badalà- compared to the other corneal transplant techniques is a very quick vision recovery: usually the patient recovers normal vision in 15 days.

The transplanted tissue’s rejection, because of the very little dimension of the donor tissue, is basically absent and this makes it possible to minimize the anti-rejection therapy with cortisone based drugs which has several collateral effects.

Furthermore, in this kind of corneal transplant no suture stitches are needed because the incision, through which tissue is implanted, is very small (about 3mm) and it closes by itself.

The eye remains intact: for an inexperienced examiner the fact that corneal transplant has been performed could go unnoticed.

“The main disadvantage of this technique is that the patient must stay in a supine position for 24h after surgery, a small sacrifice if compared with the result. ”.