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DMEK · DSAEK · PK: Cairo Corneal Transplant Center

Corneal Transplant by Dr. Shaarawy

US-trained corneal specialist · 20+ years in corneal surgery · Cairo referral center

A corneal transplant (keratoplasty) is a surgical procedure that replaces damaged corneal tissue with healthy donor tissue to restore vision, treating corneal scarring, endothelial failure such as Fuchs dystrophy, and advanced keratoconus.

DMEK, DSAEK, DALK & PK, all techniques under one roof · cost from $2,500-$4,500

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Select a date and time, Dr. Shaarawy will review your scans and recommend the right procedure.

Do you wake up with foggy vision?

Corneal edema symptoms as you actually see them

Endothelial dystrophy (Fuchs / inner-cell loss) causes foggy vision that's worst in the morning and improves slightly through the day. Drag the divider to see what patients experience.

Normal vision

With corneal edema

Driving at night

Soft halos and glare around lights, especially in low-light conditions

Read this text clearly

A clear inner cornea keeps vision crisp

Read this text clearly

A clear inner cornea keeps vision crisp

Normal vision

With corneal edema

Reading

Foggy as if looking through a misted window, worst in the morning

Normal vision

With corneal edema

Eye chart

Uniformly blurred letters, improves slightly through the day but never sharpens

Book an inner cornea assessment Ask on WhatsApp

A cell count and a corneal thickness scan show the state of the inner layer, not this picture.

Which transplant do I need?

The right procedure depends on which corneal layers are affected. Dr. Shaarawy will confirm after examining your scans.

Most advanced

DMEK

زراعة القرنية البطانية

Thinnest graft available, fastest visual recovery for Fuchs dystrophy and endothelial failure.

Learn more →Reliable

DSAEK

زراعة القرنية البطانية الجزئية

Larger donor disc with excellent outcomes, the established standard for endothelial disease.

Learn more →Full cornea

PK / PKP

زراعة القرنية الكاملة

Full-thickness corneal replacement, indicated for advanced scars, keratoconus, and stromal disease.

Learn more →

Evidence-based comparison

DMEK vs DSAEK: which is better for endothelial disease?

Both procedures treat endothelial disease (Fuchs dystrophy, bullous keratopathy), but outcomes diverge. Every clinical outcome figure below comes from a named peer-reviewed paper with its PMID. The graft-thickness row is the accepted anatomical description of the two techniques, and the cost row is this clinic’s own pricing.

What this means for you

The table below shows DMEK has higher average visual acuity and a lower two-year rejection rate in the cited studies, but the surgery is more technically demanding and needs a repeat air injection (re-bubble) more often. DSAEK is easier to perform and suits complex eyes, such as those with silicone oil or an uneven cornea. Dr. Shaarawy determines the right technique after examining your eye, not from these figures alone.

Probability of a rejection episode at 1 and 2 years

Data: Anshu A, Price MO, Price FW Jr, Ophthalmology 2012;119(3):536-540 (PMID 22218143). Kaplan-Meier analysis of 141 DMEK eyes vs 598 DSEK eyes at one centre under an identical steroid regimen. These are the only two time points the paper publishes.

DMEKlower rejection riskDSAEKhigher rejection risk

Bottom line: in that comparison DMEK eyes carried roughly 15× lower risk of a rejection episode than DSEK eyes (95% CI 2.0-111; P=0.008), and roughly 20× lower than penetrating keratoplasty. Median follow-up was 13 months; the paper publishes no five-year figures.

Criterion	DMEK	DSAEK
Tissue transferred and its thickness The accepted anatomical description of what each technique transplants, not an outcome taken from the papers cited below	Descemet's membrane + endothelium, ≈ 10-15 μm	posterior stroma + Descemet's + endothelium, ≈ 100-150 μm
Mean corrected visual acuity across published series Deng 2018; follow-up 5.7-68 months for DMEK, 9 months for DSEK	20/21-20/31	20/34-20/66
Cumulative probability of a rejection episode at 2 years Anshu 2012; one centre, one steroid regimen. Penetrating keratoplasty was 18% in the same comparison	1%	12%
Primary graft failure Pooled means from the 2018 AAO assessment	1.7% (0-12.5%)	5% (0-29%)
Graft detachment requiring air injection (re-bubble) The most common DMEK complication; the Cochrane review also found dislocation more frequent with DMEK (RR 5.40)	28.8% (0.2-76%)	14% (0-82%)
Surgical difficulty This is why DMEK is concentrated in a few centres, Dr. Shaarawy was the first to perform it in Egypt	High, requires expertise	Moderate
Suitability for complex eyes DSAEK handles silicone oil or uneven cornea better	Limited	Excellent choice
Estimated cost in Cairo This clinic's own pricing, not a published figure. The difference is small; the decision is clinical first	from $3,000	from $3,500

Tissue transferred and its thickness

DMEK

Descemet's membrane + endothelium, ≈ 10-15 μm

DSAEK

posterior stroma + Descemet's + endothelium, ≈ 100-150 μm

The accepted anatomical description of what each technique transplants, not an outcome taken from the papers cited below

Mean corrected visual acuity across published series

DMEK

20/21-20/31

DSAEK

20/34-20/66

Deng 2018; follow-up 5.7-68 months for DMEK, 9 months for DSEK

Cumulative probability of a rejection episode at 2 years

DMEK

DSAEK

12%

Anshu 2012; one centre, one steroid regimen. Penetrating keratoplasty was 18% in the same comparison

Primary graft failure

DMEK

1.7% (0-12.5%)

DSAEK

5% (0-29%)

Pooled means from the 2018 AAO assessment

Graft detachment requiring air injection (re-bubble)

DMEK

28.8% (0.2-76%)

DSAEK

14% (0-82%)

The most common DMEK complication; the Cochrane review also found dislocation more frequent with DMEK (RR 5.40)

Surgical difficulty

DMEK

High, requires expertise

DSAEK

Moderate

This is why DMEK is concentrated in a few centres, Dr. Shaarawy was the first to perform it in Egypt

Suitability for complex eyes

DMEK

Limited

DSAEK

Excellent choice

DSAEK handles silicone oil or uneven cornea better

Estimated cost in Cairo

DMEK

from $3,000

DSAEK

from $3,500

This clinic's own pricing, not a published figure. The difference is small; the decision is clinical first

The clinical outcome rows above (visual acuity, immune rejection, primary graft failure, and detachment requiring re-bubbling) come from the published literature, not from this clinic's own record: Deng SX et al., Ophthalmology 2018;125(2):295-310 (PMID 28923499); Anshu A, Price MO, Price FW Jr, Ophthalmology 2012;119(3):536-540 (PMID 22218143); Stuart AJ et al., Cochrane Database Syst Rev 2018;6(6):CD012097 (PMID 29940078); Melles GRJ et al., Cornea 2006;25(8):987-990 (PMID 17102683). The time windows quoted are those studies' follow-up periods, not five years. Two rows are not from those papers: the graft-thickness figures are the accepted anatomical description of what each technique transplants, and 'Estimated cost in Cairo' is this clinic's own pricing, not a published figure.

Choose DMEK if…

Diagnosis: uncomplicated Fuchs dystrophy or endothelial failure
Priority: best achievable visual acuity and lowest rejection risk
Eye is free of silicone oil or complex intraocular lenses

Choose DSAEK if…

Complex eye (silicone oil, complex IOL, uneven cornea)
Prior failed DMEK
Patient cannot maintain strict face-down positioning

Clinical note: the final DMEK vs DSAEK decision depends on topography, endothelial cell count, and corneal status, not on aggregate figures alone. Dr. Shaarawy recommends the right technique after examination.

Book an exam to confirm which technique fits

Corneal transplant cost estimate

See procedure pricing and get a personalized estimate on our dedicated cost page.

Cost calculator

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$Dr. Ahmed Shaarawy, Consultant Corneal & Refractive Surgeon$

Why choose Dr. Ahmed Shaarawy?

Lecturer at the Research Institute of Ophthalmology and Corneal Surgery Consultant. Cornea clinical & research fellow at Devers Eye Institute, Portland, Oregon (under Prof. Mark Terry). First surgeon to perform S-DMEK in Egypt and the Arab world. Published novel DMEK and DALK techniques at the American Academy of Ophthalmology.

+20

years

of corneal surgery experience

🇺🇸

Devers

Cornea Fellowship, Oregon, USA

+5,000

procedures

from Dr. Shaarawy's own operative record, 20+ years

AAO

published

Smart Splash & Graft Exchange DALK techniques

Letter of recommendation

In Prof. Mark Terry's own words

Excerpts from the letter Prof. Mark A. Terry, Director of Corneal Services at the Devers Eye Institute, wrote for Dr. Shaarawy on 25 January 2015, at the end of his time in Portland.

In surgery, Ahmed assisted me in complex cataracts, anterior segment reconstructions, ocular surface reconstructions, and all forms of corneal transplantation including DMEK, DSAEK, DALK and PK. I often relied upon his observations during surgery and his objective advice when we got into difficult situations on complex cases. I have no doubt that he will deliver the kind of surgical care that will be the envy of his peers when he returns to Egypt.

In his research efforts for his thesis on relaxing incisions in DALK and PK patients, Ahmed was thoughtful and thorough and his insights have advanced the field. He initiated multiple experiments in the laboratory looking at endothelial damage from the iris and the IOL that can occur in DSAEK and DMEK surgery. In addition, he demonstrated amazing ingenuity in his laboratory experiments with alternate ways to unscroll the DMEK graft in the anterior chamber, a key stumbling block for many novice DMEK surgeons.

Legacy Health letterhead: Letter of Recommendation, Ahmed Mohammad Alshaarawy

In summary: Dr. Ahmed Alshaarawy is an excellent and compassionate clinician, a surgeon on the cutting edge of corneal transplant techniques, and a scientist with unique perspectives and boundless energy that will lead to exciting discoveries in our field. Whatever clinical and academic program he chooses will benefit immensely from his membership. Mark A. Terry, M.D., Director, Corneal Services, Devers Eye Institute, January 25, 2015.

Tripoli, March 2022

Libya's national corneal transplant programme

Visiting surgeon for the programme the Libyan Ministry of Health launched at Tripoli University Hospital: about 20 corneal transplants in one week, restarting the surgery there after a pause of nearly eight years.

The full story and sources

+25

patient countries

4.9/5

patient rating

120+ reviews across Google, Meta, Vezeeta and Endorsal · August 2026

Real patient experience

Watch a real patient's experience with Dr. Ahmed Shaarawy

A real patient talks through the whole thing, from diagnosis to restored vision after DMEK corneal transplantation.

Real patient experience

A full corneal transplant after years of delaying surgery

A patient from Al-Arish, fifteen days after a full-thickness corneal transplant for keratoconus. He put off surgery for years, until a partial transplant was no longer possible, and Dr. Ahmed Shaarawy explains why deciding early can avoid a full transplant.

"I was afraid the night before the operation, I was hesitant too, at my age."

★★★★★

Real patient experience

A patient from Saudi Arabia after a repeat full-thickness transplant

A patient from Saudi Arabia who works in the medical field. A full-thickness transplant done elsewhere had failed, so Dr. Ahmed Shaarawy repeated it. About six months on, with the stitches still in, his vision with glasses is 6/9 and his astigmatism only 3 diopters.

"Thank God, it was really excellent, and I felt reassured from the first step to the last."

★★★★★

Real patient experience

A patient from Bahrain after a first transplant failed

Jamal, from Bahrain, two weeks after a repeat full-thickness corneal transplant, after more than eighteen years of corneal disease and a first operation that failed.

"I was afraid and hesitant, because the old transplant had left me frustrated and hopeless."

★★★★★

What happens, step by step

Consultation & Imaging

Comprehensive slit-lamp exam, corneal topography (Pentacam), endothelial cell count, and anterior segment OCT. We confirm the diagnosis and choose the right procedure for you.

Pre-operative Planning

Donor tissue is ordered from an accredited eye bank. Systemic health is optimized. You receive detailed written instructions for the day of surgery.

Surgery

Performed under local or general anesthesia. DMEK/DSAEK: typically 10-30 minutes. PK: 20-30 minutes. DALK: 30-40 minutes. You go home the same day or the next morning.

Week 1 Recovery

Face-down positioning (DMEK/DSAEK) for the first 24-48 hours helps graft adherence. Anti-rejection drops begin immediately. Vision is blurry but improving.

Long-term Follow-up

Visits at 1 week, 1 month, 3 months, 6 months, then annually. Final vision typically stabilizes by 3-6 months. Lifelong anti-rejection drops required.

Patient experiences

S.M.

Saudi Arabia · DMEK

“After years of blurry vision from Fuchs dystrophy, DMEK gave me 20/25 vision within three months. Dr. Shaarawy's team was professional throughout.”

K.A.

Iraq · PK

“Advanced keratoconus had taken my vision to counting fingers. Six months post-PK I'm reading without glasses again. Life-changing surgery.”

R.E.

Egypt · DSAEK

“I traveled to Cairo specifically for Dr. Shaarawy after reading about his DMEK experience. The outcome exceeded every expectation.”

Initials only, full names withheld for patient privacy.

FAQ

Frequently asked questions

Everything you need to know before deciding on corneal transplant surgery

How long does corneal transplant surgery take?

DMEK and DSAEK typically take 10-30 minutes under local anesthesia. Penetrating keratoplasty (PK) takes 20-30 minutes, and DALK takes 30-40 minutes. Most patients are discharged the same day or the following morning. The pre-operative preparation adds 1-2 hours, so plan for a half-day at the clinic.

What is the success rate for corneal transplant?

Graft survival depends first on why the transplant was needed and which technique was used, not on a single number: keratoconus is one of the best indications there is, while eyes with active inflammation or corneal vessels are far harder. On rejection, endothelial keratoplasty carries a significantly lower risk than full-thickness PK (Anshu, Price & Price, Ophthalmology 2012;119(3):536-540, PMID 22218143), and for DMEK the probability of an immune reaction at four years was 2.3% across 1,000 consecutive eyes (Hos et al., Ophthalmology 2017;124(4):512-518, PMID 28094043). Those are published figures, not this clinic's own series. Early detection and treatment of rejection episodes typically saves the graft.

How long is the recovery period?

Initial functional vision returns within 2-6 weeks for DMEK/DSAEK. Full stabilization typically takes 3-6 months. PK recovery is longer, 12-18 months for stable refraction, because sutures must be gradually removed as astigmatism is managed. You can usually resume desk work within 1-2 weeks.

Will I need to take drops for life?

Yes, topical corticosteroid drops (e.g., prednisolone 0.5% or 1%) are required lifelong to prevent immune rejection. Frequency is tapered over the first year from four times daily to once daily. Missing drops significantly increases rejection risk. This is the most important thing you can do to protect your graft.

What is the risk of rejection?

Rejection risk depends on the technique used. For DMEK the probability of an immune reaction at four years was 2.3% across 1,000 consecutive eyes (Hos et al., Ophthalmology. 2017;124(4):512-518, PMID 28094043), and DMEK carries a significantly lower rejection risk than DSAEK or penetrating keratoplasty (Anshu, Price & Price, Ophthalmology. 2012;119(3):536-40, PMID 22218143). Those are published figures, not this clinic's own series. Rejection is NOT the same as failure, rejection episodes caught early and treated with intensive steroids are reversed in the majority of cases. Signs to watch for: sudden redness, pain, light sensitivity, or rapid vision blurring. Contact us immediately if these occur.

Does insurance cover corneal transplant in Egypt?

Egyptian national insurance schemes do not typically cover the full cost of corneal transplant at private specialist clinics. International travel insurance and some Gulf-region corporate policies do cover it. We can provide detailed cost documentation and a medical report to support your insurance claim.

Can I travel back home after surgery?

For DMEK/DSAEK, we recommend staying in Cairo for at least 5-7 days to confirm graft adherence and manage any early complications. For PK, a 7-10 day stay is advisable. Flying after graft surgery is generally safe once cleared by Dr. Shaarawy, typically from day 5 onwards with no face-down requirement.

What is the cost of corneal transplant in Cairo?

Procedure cost ranges from $2,500 (DALK) to $4,500 (DSAEK) per eye depending on the procedure type, whether combined with cataract surgery, and your location. Use the cost calculator on our cost page for a personalized estimate. A $1,000 deposit is required to book surgery and arrange donor tissue.

How do I know which transplant I need, DMEK, DSAEK, or PK?

The choice depends on the layer of the cornea that is diseased. DMEK/DSAEK replace only the back (endothelial) layer, used for Fuchs dystrophy, bullous keratopathy, and failed previous grafts. PK replaces the full corneal thickness, used for advanced keratoconus, stromal scars, infections, and perforations. A corneal topography and endothelial cell count are required to decide.

What is Dr. Shaarawy's experience with DMEK?

Dr. Ahmed Shaarawy performed the first S-DMEK (S-stamp DMEK) in Egypt and the Arab world. He trained under Prof. Mark Terry at Devers Eye Institute, Oregon, one of the world's highest-volume DMEK centers. He has published novel surgical techniques at the American Academy of Ophthalmology (Smart Splash, Graft Exchange DALK).

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Medical References

Price MO, Giebel AW, Fairchild KM, Price FW Jr. "Descemet's membrane endothelial keratoplasty: prospective multicenter study of visual and refractive outcomes and endothelial survival." Ophthalmology. 2009;116(12):2361-2368 (PMID 19875170).
Gain P, Jullienne R, He Z, Aldossary M, et al. "Global Survey of Corneal Transplantation and Eye Banking." JAMA Ophthalmol. 2016;134(2):167-173 (PMID 26633035).
Deng SX, Lee WB, Hammersmith KM, Kuo AN, et al. "Descemet Membrane Endothelial Keratoplasty: Safety and Outcomes: A Report by the American Academy of Ophthalmology." Ophthalmology. 2018;125(2):295-310 (PMID 28923499). Mean BCVA after DMEK ranged from 20/21 to 20/31, immune rejection averaged 1.9% (range 0-5.9%), and graft survival ranged from 92% to 100% at last follow-up.
Hos D, Tuac O, Schaub F, Stanzel TP, et al. "Incidence and Clinical Course of Immune Reactions after Descemet Membrane Endothelial Keratoplasty: Retrospective Analysis of 1000 Consecutive Eyes." Ophthalmology. 2017;124(4):512-518 (PMID 28094043). Probability of an immune reaction was 2.3% at four years.
Dr. Ahmed Shaarawy: 20+ years in corneal surgery, Devers Eye Institute fellowship (Portland, Oregon), and two surgical techniques published in the AAO video series.