This procedure replaces only the inner lining cells (known as endothelial).  These cells are responsible for keeping the cornea clear and, when they malfunction or are lost, cloudiness develops because of excessive retained fluid. 

The patient’s endothelial cells are removed by peeling off the membrane upon which they sit (Descemet’s membrane).  The donor Descemet’s membrane is peeled off, and it is the only tissue that’s implanted.  No sutures are used to hold the transplant, as the pumping action of the endothelial cells should cause the tissue to “stick” in place.