PDEK (Pre-Descemet's Endothelial Keratoplasty) in Mumbai – Kurla BKC, Kalina & Bandra W

PDEK is a highly refined partial-thickness corneal transplant that replaces only the innermost layers of the cornea — the Descemet's membrane and its endothelial cells — while leaving the healthy anterior stroma untouched. It is the most tissue-conservative and anatomically precise corneal transplant currently available.

What Is PDEK (Pre-Descemet's Endothelial Keratoplasty)?

In PDEK, donor tissue consisting of Descemet's membrane, its pre-Descemet's layer, and the endothelium is prepared using an air injection technique and transplanted into the recipient eye through a small 3–4 mm incision. The graft unfolds and attaches to the recipient's cornea using an air bubble.

Who Is It For?

This procedure is generally suited to patients meeting the following criteria:

Fuchs' endothelial dystrophy
Bullous keratopathy (failed endothelial cells from previous cataract surgery or other causes)
Eyes with a clear anterior cornea requiring only endothelial replacement

What Happens During the Procedure?

Each step is performed with precision and patient comfort in mind.

Step 1: Donor tissue carefully prepared in the surgical theatre
Step 2: Diseased endothelium stripped from the recipient eye
Step 3: Folded donor graft inserted through a small incision
Step 4: Air bubble injected to press graft into position
Step 5: Patient rests face-up for 1 hour post-operatively to maintain the bubble

Recovery & What to Expect

Vision improves more rapidly than with full-thickness transplants — most patients notice meaningful improvement within 4–8 weeks. No sutures to remove. Steroid drops are continued for 1 year. Regular follow-up includes endothelial cell counts to monitor graft health.

Benefits

Patients choosing this procedure typically experience the following benefits:

No external sutures — lower rejection risk, faster recovery
Smaller incision — structurally stronger eye post-operatively
Faster visual rehabilitation than penetrating keratoplasty
Preserves the patient's own healthy anterior cornea

FAQFrequently Asked Questions

How is PDEK different from DSAEK?

Both replace only the endothelium, but PDEK uses a thinner, more anatomically natural graft (including the pre-Descemet's layer) which adheres better and may give superior visual outcomes. PDEK is technically more demanding to prepare and transplant.

Is there a waiting list for donor tissue?

Donor availability varies. Dr. Mickey works with established eye banks to minimise waiting times. We will advise you on expected timelines at your consultation.

Considering pdek?

Book a personalised consultation with Dr. Mickey. We'll evaluate your eyes carefully and walk you through whether this procedure is right for you.

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This page is informational only and is not a substitute for medical consultation. Eligibility, outcomes, and risks of any clinical procedure depend on an in-person assessment.