Corneal transplant · Endothelial keratoplasty
DMEK & DSEK Corneal Transplants in Fort Worth & Colleyville, TX
DMEK and DSEK replace only the damaged inner layer of the cornea to clear the swelling and cloudy vision caused by Fuchs’ dystrophy and other endothelial disease. Fellowship-trained cornea surgeon Dr. David Truong performs both for patients across Fort Worth, Colleyville, Keller, and the DFW area.
The short answer
What are DMEK and DSEK?
DMEK (Descemet’s membrane endothelial keratoplasty) and DSEK (Descemet’s stripping endothelial keratoplasty) are partial-thickness corneal transplants that replace only the cornea’s inner endothelial layer. They treat corneal swelling from Fuchs’ dystrophy and other endothelial failure, and they heal faster than a traditional full-thickness transplant.
Both are outpatient procedures performed through a small incision, usually without the ring of stitches a full transplant needs. Dr. Truong evaluates your cornea and recommends the technique that fits your eye.
The endothelium
Why does the cornea swell and turn cloudy?
The innermost layer of your cornea, the endothelium, is a single sheet of cells that pumps fluid out so the cornea stays thin and clear. These cells do not regenerate. When too many are lost, fluid builds up, the cornea swells, and vision becomes blurry, hazy, or glare-filled, often worst in the morning.
Dr. Truong may recommend DMEK or DSEK for:
- ✓Fuchs’ endothelial dystrophy, the most common reason for endothelial transplants. Learn about Fuchs’ dystrophy.
- ✓Pseudophakic bullous keratopathy, corneal swelling that develops after cataract surgery.
- ✓Corneal decompensation after other eye surgery or injury.
- ✓Congenital endothelial dystrophies present from birth.
- ✓Other endothelial conditions that cause persistent corneal edema.
Compare
DMEK vs. DSEK: what’s the difference?
Both are endothelial keratoplasty. The main difference is how thin the donor graft is.
| DSEK (DSAEK) | DMEK | |
|---|---|---|
| Donor tissue | Endothelium plus a thin layer of donor stroma | Only Descemet’s membrane and endothelium |
| Graft thickness | Thicker | Ultra-thin, about 10–15 microns |
| Rejection risk | Low | Lowest of any corneal transplant |
| Visual recovery | Gradual; very good vision for most | Often faster, closest to a natural cornea |
| Surgical complexity | Easier graft handling | More technically demanding |
DSEK can be the better choice for eyes with more complex anatomy, such as after prior glaucoma surgery. Because DMEK is technically demanding, it should be performed by a surgeon with subspecialty cornea training.
Step by step
How is DMEK or DSEK performed?
Both procedures are done on an outpatient basis, typically in under an hour, with local anesthesia and mild sedation.
Remove the damaged layer
Dr. Truong gently removes the diseased endothelium from the back of your cornea.
Insert the donor graft
Prepared donor tissue is inserted through a small incision at the edge of the cornea.
Position with air
An air bubble floats the graft up against the back of your cornea so it can attach.
Rest face-up
You lie face-up for a period after surgery to help the graft stay in place, then go home the same day.
Recovery
What is recovery like after a corneal transplant?
Many patients notice clearer vision within the first few weeks after DMEK. Recovery after DSEK is usually more gradual. Your vision continues to improve over the following months as the cornea clears.
- ✓Eye drops to prevent infection and protect the graft from rejection, used as directed.
- ✓No rubbing or strenuous activity while the graft attaches and heals.
- ✓Regular follow-up visits at our Fort Worth (Alliance) or Colleyville office to monitor healing.
Call us the same day at (817) 886-4600 if you notice new redness, light sensitivity, a drop in vision, or eye pain. These can be early signs of graft rejection, which usually responds to medication when caught early.
Benefits
Why DMEK and DSEK replaced most full-thickness transplants
Compared with a traditional full-thickness transplant (penetrating keratoplasty), endothelial keratoplasty offers:
Faster visual recovery
Vision often improves in weeks instead of the many months a full transplant can take.
Few or no stitches
A small incision avoids the ring of sutures used in a full-thickness transplant.
Less astigmatism
Keeping your own corneal surface intact limits irregular astigmatism.
Lower rejection risk
Less donor tissue means a lower chance of rejection, lowest with DMEK.
A stronger eye
Your cornea stays structurally intact and less vulnerable to injury.
Outpatient surgery
Most patients go home the same day with drops and a follow-up plan.
Your surgeon
Why choose Dr. Truong for DMEK or DSEK?
Dr. David Truong is a board-certified ophthalmologist who completed his fellowship in cornea and refractive surgery at UCLA’s Jules Stein Eye Institute after residency at UT Southwestern Medical Center in Dallas. He performs both DMEK and DSEK, so your technique is chosen for your eye rather than a surgeon’s single preference.
- ✓Subspecialty cornea training in endothelial and full-thickness transplantation.
- ✓Care for related conditions, including Fuchs’ dystrophy and cataracts that often occur alongside it.
- ✓Adjunct Assistant Professor at UT Southwestern.
- ✓Two offices in Fort Worth (Alliance) and Colleyville for consultations and follow-up.
For eye care providers
Referring a patient with corneal edema?
Optometrists and ophthalmologists across DFW can refer patients with Fuchs’ dystrophy, bullous keratopathy, or failing grafts directly to Dr. Truong. Your patient returns to you for routine care after surgery.
Send a referralTwo locations
Corneal transplant care near you in Fort Worth and Colleyville
Consultations and follow-up visits are available at both offices, with Dr. Truong and optometrist Dr. Samantha Reynolds. Both offices are open Monday–Thursday 8:00 am–5:00 pm and Friday 8:00 am–3:00 pm.
(817) 886-4600
(817) 886-4600
Coming from Keller or Southlake? See eye surgery for Keller and Southlake patients.
FAQ
DMEK and DSEK FAQs
Is DMEK better than DSEK?
DMEK often gives faster, sharper vision and has the lowest rejection risk of any corneal transplant, but it is more technically demanding. DSEK can be the better option for eyes with complex anatomy. Dr. Truong performs both and recommends the one that fits your eye.
How long does it take to recover from DMEK?
Many patients notice clearer vision within the first few weeks after DMEK. DSEK recovery is usually more gradual. Vision keeps improving over several months, with eye drops and regular follow-up visits along the way.
Is DMEK a full corneal transplant?
No. DMEK replaces only the innermost layer of the cornea, Descemet’s membrane and the endothelium. The rest of your own cornea stays in place, which is why healing is faster and the eye stays stronger.
What are the signs of corneal graft rejection?
Watch for new redness, light sensitivity, a drop in vision, or eye pain. Call Azure Eye Center the same day at (817) 886-4600 if any of these appear. Rejection caught early usually responds to medicated eye drops.
Can DMEK be combined with cataract surgery?
Yes, in many cases. Fuchs’ dystrophy and cataracts often occur together, and Dr. Truong may combine cataract surgery with DMEK or perform them in stages, depending on your cornea.
Does insurance cover DMEK or DSEK?
Corneal transplants for medically necessary conditions such as Fuchs’ dystrophy are generally covered by Medicare and most insurance plans. Our team verifies your benefits and explains any costs before surgery.
Where can I get DMEK or DSEK near Fort Worth or Keller?
At Azure Eye Center, with offices in Fort Worth (Alliance) at 3900 N Tarrant Pkwy and in Colleyville at 5203 Heritage Avenue. Patients also come from Keller, Southlake, Grapevine, and North Richland Hills. Call (817) 886-4600 to schedule.
Related pages
Talk with a cornea specialist about DMEK or DSEK
Schedule a cornea consultation in Fort Worth or Colleyville. Dr. Truong will measure your cornea, explain your options, and recommend the right transplant for your eye.
This page is for general education and is not medical advice. Candidacy, treatment options, risks, and results vary by patient and are determined at an in-person exam with your eye doctor.