A healthy corneal endothelium is required for corneal clarity. Endothelial dysfunction or damage can result in corneal edema and visual impairment. Therapeutical approaches have undergone a profound evolution over recent years. Descemet membrane endothelial keratoplasty (DMEK) allows for selective replacement of damaged endothelial cells, using only donor Descemet’s membrane with endothelium. DMEK has gained popularity for many surgeons to treat specific endothelial failure cases and it offers early rehabilitation with optimal visual acuity. Its minimally invasive nature and low immunological rejection rate make this technique favorable for surgeons.

As clinical evidence for DMEK efficacy builds, there is increasing interest for surgeons to adopt DMEK to provide patients with the best possible outcomes. The learning curve, however, has proven to be much steeper than previous endothelial keratoplasty procedures. Surgical challenges often make necessary additional procedures that can critically affect functional prognosis. Current challenges in the refinement of DMEK techniques include improving graft preparation, delivery, unfolding, and positioning in the recipient's eye, reducing surgical time and complication rates, developing pre- and intraoperative manipulations to better identify DMEK graft orientation, and the use of gas bubble tamponade.

The aim of this Special Issue is to solicit original research articles, as well as review articles, relating to advances and innovations in DMEK surgery, and a critical revision of current knowledge. Basic science and technology research contributions are strongly encouraged.

Potential topics include but are not limited to the following:

• DMEK learning curve
• Eye banking advancements in DMEK tissue preparation
• Outcomes, evolution, and comparison of surgical techniques for DMEK
• Features, indications, advantages, and possible complications of DMEK
• Management of complications in DMEK
• Post-operative endothelial detachment prevention and surgical management
• Technological innovations in surgical instrumentation
• Basic science contributions to endothelial dysfunction
• DMEK in glaucoma
• DMEK in diabetics
• Refractive surgical outcomes after DMEK
• Repeated DMEK
• DMEK after Penetrating Keratoplasty (PK)
• DMEK after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK)