Descemet membrane endothelial keratoplasty (DMEK)
This is the newest type of corneal transplantation that is only being done at a limited number of locations.
During this procedure, the surgeon removes the cells in the back of the cornea and replaces them with the identical tissue from the donor. The front of the cornea is left unchanged except for a small incision.
This surgery usually only requires one stitch compared to sixteen or more for a typical cornea transplant.
Vision returns much quicker after this surgery and there often is complete visual rehabilitation by four weeks.
The highest percentage of patients are corrected to 20/20 after this surgery compared to other types of corneal transplants.
This is usually the preferred transplant for Fuchs dystrophy.
Descemet stripping endothelial keratoplasty (DSEK)
During this procedure the cells in the back of the cornea are removed and replaced with a thin piece of cornea tissue which is attached with an air bubble.
It is similar to DMEK, but utilizes a thicker piece of tissue. Some people are not a candidate for DMEK, but are still a good candidate for this surgery.
It usually requires three stitches and vision may be finalized as soon as six weeks.
This is usually preferred for bullous keratopathy and sometimes for Fuchs dystrophy.
Anterior lamellar keratoplasty
In this partial replacement procedure only the front part of the cornea is removed and replaced with the front of another cornea. It is attached with a very fine thread which may be left in place for months or even years.
This type of surgery decreases the risk of rejection, damage from trauma, and risk of the surgery.
This surgery is often used for keratoconus, and corneal scars.
This surgery removes the full thickness of the central cornea and can be used when there is damage to all layers of the cornea.
It also uses a very fine thread that may be left in place for months or even years.
This is also often used for infections, and other conditions with severe damage.