How is it different from the thinner back-layer transplant?

One review compared Descemet membrane endothelial keratoplasty with Descemet stripping automated endothelial keratoplasty. The thinnest graft may give sharper vision in selected eyes [3] .

Will stitches be visible?

Most of the graft is inside the eye. Small incision stitches may be used, but there is no large round cornea suture pattern.

Can the graft fail later?

Yes. Pump cells can slowly decline over time. Regular cornea visits help catch problems early.

When should I call after surgery?

Call the surgeon for worse pain, redness, light sensitivity, or a sudden drop in vision.

Treatment

Descemet Stripping Endothelial Keratoplasty (DSEK/DSAEK)

Also known as Endothelial Keratoplasty, Back-Layer Cornea Transplant, DSAEK, Fuchs Dystrophy Surgery, Partial Cornea Transplant

Updated May 19, 2026·For educational purposes only. Not a substitute for medical advice. See our terms.

Bottom Line

Descemet stripping endothelial keratoplasty is a partial cornea transplant. It replaces the failed inner pump layer with a slightly thicker donor layer than newer thin-graft surgery.

Descemet stripping endothelial keratoplasty replaces the inner cornea pump layer. It is used when swelling comes from pump cell failure ¹.

The donor tissue includes pump cells and a thin layer of cornea support tissue. That extra thickness can make handling easier in some complex eyes.

Vision often improves as swelling clears. Thinner donor tissue is linked with better visual sharpness in several studies ².

How It Works

The surgeon removes the failed inner cornea lining. A donor button with healthy pump cells is placed inside the eye.

An air bubble holds the graft against the cornea. The new pump cells then pull fluid out of the cloudy cornea.

Who It Helps

This surgery helps when the cornea is cloudy because the inner pump cells are weak.

Fuchs dystrophy. This is a common reason.
Prior cataract surgery damage. The cornea may swell after cell loss.
Failed older graft. A back-layer transplant may restore clarity.

A full-thickness graft may be better when the front cornea is scarred.

Risks And Follow-Up

Risks include graft detachment, rejection, infection, high eye pressure, and graft failure.

The graft is thicker than the thinnest back-layer transplant. That can make it easier to handle in selected complex eyes.

Some people still need glasses or contact lenses after the cornea clears.

Cost And Insurance

This surgery is usually billed as medically necessary when cornea swelling limits vision.

Costs can include donor tissue, the surgery center, anesthesia, surgeon fees, and follow-up visits.

Ask your insurer whether prior authorization is needed before the surgery date.

Common Questions About Descemet Stripping Endothelial Keratoplasty

It replaces only the back layer of the cornea. A full transplant replaces the whole central cornea.

Next Steps

1Schedule a cornea consultation to confirm the diseased layer.
2Ask whether a thinner or thicker back-layer graft fits your eye.
3Arrange a ride for surgery day and the first visit.
4Use drops on the exact schedule your surgeon gives you.
5Keep long-term visits to watch for rejection or graft failure.

Find specialists for Descemet Stripping Endothelial Keratoplasty (DSEK/DSAEK)

Board-certified ophthalmologists who treat Descemet Stripping Endothelial Keratoplasty (DSEK/DSAEK).

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