11/01/2026
Combined Cataract & Corneal Transplant Surgery (DMEK) — A Behind‑the‑Scenes Look
This case involves a patient whose vision was impaired by a combination of two problems: a cloudy cataract and dysfunctional corneal endothelium — the innermost, 8‑micron‑thin layer responsible for keeping the cornea clear.
In situations like this, both issues may be treated in a single sitting.
The procedure begins with the preparation of the donor endothelial graft. This delicate layer is carefully harvested at the start of the operation and kept ready for transplantation.
Once the graft is prepared, I proceed with cataract surgery, removing the cloudy lens and replacing it with an intraocular lens implant. With the cataract addressed, the final step is to transplant the donor endothelium into the patient’s eye — a step that requires precision, patience, and a deep respect for the tissue. Corneal endothelial cells don't regenerate so it's vital that we safeguard each and every cell. A healthy corneal donor will have 2300 cells per square millimetre. The diameter of the donor disc that is transplanted is usually 8mm.
The full surgery takes around 45 minutes, but this video condenses the key moments into a 5‑minute overview, giving a glimpse into how these two sight‑restoring procedures come together seamlessly.