Descemetorhexis without endothelial keratoplasty (DWEK) is a surgical procedure primarily used to treat corneal endothelial dysfunction, such as Fuchs' dystrophy. Unlike traditional endothelial keratoplasty (EK), DWEK does not involve replacing the damaged endothelial layer but focuses solely on removing the Descemet membrane, which is the innermost layer of the cornea. This procedure can provide significant improvement in corneal clarity and help patients with certain types of corneal endothelial diseases.

In the DWEK procedure, the Descemet membrane, which has been damaged due to disease, is carefully removed from the cornea. The surgery is typically performed when there is significant endothelial cell loss but no need for a full corneal transplant. This method aims to restore the normal function of the cornea by removing the dysfunctional layer and allowing the remaining corneal structures to heal and regenerate.

The advantages of DWEK over traditional EK include the avoidance of a donor endothelial graft, which reduces the risks associated with graft rejection. Additionally, it can be performed without the need for sutures, leading to quicker recovery times. Patients who undergo this procedure often experience clearer vision as the corneal function is restored, even without a complete transplant of the endothelial layer.

While DWEK has shown promise in treating certain corneal endothelial diseases, it may not be suitable for all patients, particularly those with more advanced endothelial degeneration. However, for those with suitable conditions, DWEK offers a minimally invasive option for improving corneal clarity and preserving vision.