Descemet Membrane Endothelial Keratoplasty (DMEK) has replaced DSAEK as the gold standard endothelial keratoplasty in many centres. The key outcome advantage of DMEK over DSAEK is:

• A Lower graft dislocation rate and easier surgical technique
• B Lower endothelial cell loss at 1 year
• C Superior visual outcomes approaching best spectacle-corrected VA with less irregular astigmatism ✓
• D Ability to perform the surgery under topical anesthesia

Explanation

DMEK transplants only the Descemet membrane and endothelium (~10–15 µm tissue) without any posterior stroma, producing a refractive interface that is essentially transparent and native-thickness. This results in significantly superior visual outcomes — many patients achieving 20/20 or better — compared to DSAEK (which transplants a thicker tissue flap causing some residual hyperopic shift and interface reflections). DMEK does have higher dislocation rates and greater technical difficulty than DSAEK. The superior visual recovery is its defining advantage.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.