Specialist DMEK corneal transplantation for Fuchs' dystrophy — the ultra-thin inner-layer graft with the fastest recovery and lowest rejection rate. Combined with cataract surgery where needed in a single operation. Led personally by Mr Hatch Mukherjee, fellowship-trained corneal transplant surgeon.
DMEK is the most technically demanding corneal transplant procedure — transplanting a sheet of tissue just 10–15 microns thick requires exceptional precision and experience. It is not performed at all transplant centres, and outcomes vary significantly with surgical volume and expertise.
Mr Mukherjee is a fellowship-trained corneal surgeon with over 20 years' experience in anterior segment surgery, including DMEK for Fuchs' dystrophy and other endothelial disease. He performs the procedure using femtosecond laser assistance for accuracy not possible with manual technique, and routinely combines DMEK with cataract surgery where indicated — addressing both conditions in a single, carefully planned operation.
Sub-specialist corneal expertise: Mr Mukherjee's triple fellowship in corneal disease, refractive surgery and glaucoma means your entire anterior segment is managed by a single expert who understands the full picture.
You see the consultant, always: Every consultation, every operation and every follow-up appointment is with Mr Mukherjee personally. Your Fuchs' journey is never delegated to a junior team member.
Femtosecond laser precision: Laser-assisted preparation of the donor graft achieves micron-level cut accuracy, improving graft handling, attachment and reproducibility compared with manual technique.
Fuchs' dystrophy is a hereditary condition affecting the endothelium — the single innermost layer of cells lining the cornea. These pump cells maintain corneal clarity by keeping excess fluid out of the corneal tissue. In Fuchs', they progressively fail and die. As cell density falls, the cornea gradually waterloggs and thickens. Vision becomes increasingly blurred — typically worse on waking and improving through the day. Over time, the cornea becomes permanently hazy, and in advanced disease, painful blisters form on the surface.
Characteristically worse in the morning and improving through the day as the eye is open and evaporation reduces corneal swelling. A hallmark symptom of Fuchs'.
Especially at night or in bright light — lights appear to have a haze or starburst around them. Often mistaken for an uncorrected refractive error or early cataract.
Visual clarity varies across the day or between humid and dry conditions. May be dismissed as tiredness. An endothelial cell count is needed to distinguish this from dry eye disease.
In later stages, corneal blisters (bullous keratopathy) cause significant pain and light sensitivity. This indicates advanced disease requiring prompt surgical assessment.
Note: Early Fuchs' closely mimics dry eye disease — glare, fluctuating vision and general visual fatigue. If drops are not helping your symptoms, a specialist assessment including endothelial cell count and corneal thickness measurement is warranted.
DMEK (Descemet Membrane Endothelial Keratoplasty) selectively removes only the failed endothelial layer and replaces it with a precisely prepared donor graft just 10–15 microns thick — a fraction of a human hair. The rest of your own cornea is preserved.
Procedure details: Performed under local anaesthetic — awake but completely comfortable throughout. Day case surgery: you arrive, have the procedure and go home the same day. A small air bubble holds the graft in position while it attaches naturally. No sutures are required. Visual improvement begins within days to weeks as the graft settles.
Signs & symptoms to look for: Reduced contrast sensitivity is also common — colours may appear washed out and faces harder to distinguish in low-contrast settings. Family history is significant: first-degree relatives of affected patients are at elevated risk and should ask their optometrist to check for early signs.
Fuchs' dystrophy and cataract commonly coexist — both cloud vision, and both would require separate surgery if treated independently. The combined DMEK and cataract procedure (known as the "triple procedure") removes the cloudy natural lens, implants a precisely calculated artificial lens and replaces the diseased endothelium in a single, carefully staged operation.
One anaesthetic. One recovery. One set of follow-up visits. For appropriate patients this is both the most efficient and the best clinical approach — avoiding the risks of performing cataract surgery on a recently transplanted cornea, and shortening the total time from diagnosis to clear vision.
Mr Mukherjee will assess at consultation whether combined surgery is indicated, or whether staged procedures are more appropriate for your clinical situation.
No NHS waiting list. Timeline is determined by your clinical need, not hospital capacity. NHS waiting times for DMEK in many parts of England currently exceed 12 months — during which Fuchs' continues to progress.
Mr Mukherjee conducts every consultation, performs every operation and leads every follow-up personally. Your care is never delegated to a junior team member at any stage.
If both eyes are affected, Mr Mukherjee plans the sequence carefully to minimise your total time with impaired vision — coordinating the interval between operations for the best overall outcome.
No unexpected charges. All-inclusive pricing covering the procedure, consultation and standard aftercare is discussed and provided in writing at your initial assessment.
You will need to lie face-up for a period after surgery to allow the air bubble to hold the graft in place. Vision is typically blurred for the first few weeks, then progressively improves. Most patients reach their best vision within 3–6 months. Steroid drops are taken for a prolonged period to protect the graft. Regular follow-up monitors graft health and endothelial cell density.
DMEK replaces only the innermost monolayer of cells — achieving the closest anatomical match to normal corneal structure. It gives faster visual recovery than DSAEK and far faster recovery than PK (full-thickness transplant). Rejection rates are also substantially lower because less foreign tissue is introduced. In experienced hands, outcomes are consistently superior.
Many Fuchs' patients have or are developing cataract. The combined procedure addresses both in a single operation — avoiding the risk of exposing a freshly transplanted graft to a second intraocular procedure months later, reducing total anaesthetic exposure and shortening the overall recovery journey.
DMEK has the highest graft survival of any endothelial transplant technique — over 95% at 5 years in experienced hands. Rejection, when it occurs, is less common than with older techniques and often reversible with prompt steroid treatment. Long-term endothelial cell density is monitored at each follow-up visit.
Mr Hatch Mukherjee provides specialist diagnosis and surgical treatment for Fuchs' endothelial dystrophy in Colchester. You will be seen and treated by the consultant personally at every stage — from initial assessment through to long-term graft monitoring.
No referral needed. NHS and private patients welcome.
