Cornea and grafts
The cornea is a transparent structure at the front of the eye that plays an essential role in vision. When it loses its transparency or its regularity, vision can be significantly impaired. Corneal grafting is a common, standardised procedure that today gives excellent results thanks to advances in surgical technique.
What is it?
The endothelium is the innermost layer of the cornea, responsible for maintaining a constant level of hydration by pumping excess fluid out of the corneal stroma, thereby preserving its transparency. When these cells deteriorate, the cornea thickens and loses its clarity, causing a progressive decline in vision. DMEK (Descemet Membrane Endothelial Keratoplasty) replaces only this thin damaged layer with a healthy graft, without touching the rest of the cornea. In certain more complex cases, a DSAEK (Descemet Stripping Automated Endothelial Keratoplasty) is performed instead.
Most frequent indications
- Fuchs’ dystrophy
- Pseudophakic bullous keratopathy
What are the signs of endothelial disease?
- Vision that becomes progressively clouded, often more marked in the morning
- Sensitivity to light and a halo around light sources
- A sensation of fog that does not improve with glasses
- In advanced forms, eye pain related to corneal oedema
How does the surgery work?
The procedure is performed in an operating theatre. The very thin graft is introduced into the eye and positioned against the inner surface of the cornea, where it is held in place by an air bubble injected at the end of the procedure.
Key points after surgery
- Remain strictly on your back for 3 days, so that the air bubble holds the graft in place
- Apply eye drops as prescribed (anti-rejection, antibiotic)
- Avoid rubbing the eye
- Close follow-up appointments during the first days to monitor graft attachment
