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First to introduce S-DMEK in Egypt · Trained by Mark A. Terry

DMEK and S-DMEK in Cairo: by the surgeon who introduced S-DMEK in Egypt.

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DMEK (Descemet Membrane Endothelial Keratoplasty) replaces only the inner endothelial layer of the cornea, the gold standard for Fuchs dystrophy and endothelial failure. Dr. Ahmed Shaarawy was the first to introduce S-DMEK in Egypt, after training under Prof. Mark A. Terry at Devers Eye Institute, Portland, one of the original developers of the technique. From $3,000.

Watch on AAOSmart Splash (DALK)Graft Exchange after DALK
DMEK Endothelial Transplantation with Dr. Ahmed Shaarawy, Shaarawy Cornea Clinic

Why choose us

International standard. Regional access.

Fellowship under Prof. Mark A. Terry

Devers Eye Institute, Portland, Oregon, where modern DMEK was developed. Direct training in the original technique from one of its inventors.

First to introduce S-DMEK in Egypt

Dr. Shaarawy introduced the S-DMEK variant, using a tissue stamp to prevent the donor membrane from being implanted upside-down. A meaningful safety improvement.

AAO 2014 poster on DMEK outcomes

Co-author on the AAO 2014 poster showing DMEK improves vision even in eyes with prior refractive surgery, a notoriously challenging patient group.

Lowest rejection rate of any transplant

DMEK carries the lowest rejection risk of any keratoplasty: the probability of an immune reaction at four years was 2.3% across 1,000 consecutive eyes (Hos et al., Ophthalmology 2017), and DMEK's risk is significantly lower than DSAEK or PKP (Anshu, Price & Price, Ophthalmology 2012). Because only the thin inner layer is replaced, the immune response is minimized. See the references below.

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
Real patient experience

Holding the air in my hands: DMEK by air

Kholoud, from Baghdad, could hardly see with her eye and could not climb stairs. She found Dr. Ahmed Shaarawy on Facebook and had a stitch-free DMEK by air in Erbil.

"Now you know that I really did hold the air in my hands."

★★★★★

Procedures & pricing

Transparent USD pricing.

Final cost is set after clinical examination. Local-currency equivalents available on request. Insurance reports issued for international patients.

ProcedureBest forFrom (USD)
S-DMEK (S-stamp DMEK)Marked with an S-stamp for orientation, eliminates the risk of upside-down implantation.$3,000 - $3,500
Standard DMEKConventional DMEK technique. Used when S-stamp preparation isn't available.$3,000 - $3,500
DMEK + cataract surgery (triple procedure)DMEK combined with phaco + IOL in a single session. Common in Fuchs patients with cataract.$3,400 - $3,900
تجربة مريض حقيقية

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.

Common questions

Frequently asked.

Why DMEK instead of DSAEK?
DMEK transplants only the Descemet membrane and endothelial cells (about 10-15 microns thick). DSAEK includes a thin layer of stroma as well (around 100 microns). DMEK gives faster visual recovery, sharper vision, and a lower rejection rate. DSAEK is preferred only when the eye's anterior segment is too complex for DMEK (prior glaucoma surgery, very shallow chamber, etc.).
How long is recovery after DMEK?
Most patients notice clearer vision within 1-2 weeks. Full visual stability takes 3-6 months. You'll need to keep your head face-up for the first 24-48 hours so the air bubble holds the graft in place.
What's the rejection risk for DMEK?
DMEK has the lowest rejection risk of any keratoplasty. In the largest published series 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's risk is significantly lower than DSAEK or penetrating keratoplasty (Anshu, Price & Price, Ophthalmology. 2012;119(3):536-540, PMID 22218143). Those are published figures across many centers, not this clinic's own series. Most rejection episodes are reversible if caught early; topical steroids are first-line treatment.
I have Fuchs dystrophy: am I a candidate?
Almost certainly. DMEK is now considered the first-line surgical treatment for Fuchs endothelial dystrophy. We confirm candidacy with specular microscopy (endothelial cell count) and OCT.
Where does the donor tissue come from?
We import tissue from internationally certified eye banks, primarily VisionGift (USA) and Saving Sight (USA), with some European banks for specific cases. Every tissue ships with a full clinical report including donor age, endothelial cell density, and viral screening.
How does DMEK in Cairo compare to DMEK in Europe or the US?
DMEK in Cairo is around $3,000-$3,500. The same procedure costs €10,000-€18,000 in Western Europe and $25,000-$40,000 in the United States. Same surgical technique. Same outcomes. The price differential reflects operating costs, not clinical standards.
Can I have DMEK if I had LASIK or RK before?
Yes. This is a co-authored research paper Dr. Ahmed Shaarawy contributed to, published as a poster at the AAO 2014 Annual Meeting (Terry MA, Straiko MD, Veldman PB, Alshaarawy AM [Dr. Ahmed Shaarawy], Mayko Z, Poster #30039964): DMEK is feasible and beneficial in eyes with prior refractive surgery. That is a conference poster rather than a peer-reviewed article, so it carries no journal, volume, pages or PMID and no figure from it is quoted here. Clinical caveat: clearing the corneal edema can unmask unpredictable topography changes from the prior LASIK/RK, so post-operative refraction may shift more than in a virgin eye, plan for a glasses update at month 3.
What's the risk of needing a second air-bubble (re-bubble) after DMEK?
In a small percentage of cases the DMEK graft detaches partially and needs an in-clinic injection of a second air bubble to re-attach. This is co-authored work Dr. Ahmed Shaarawy contributed to, presented as an abstract at ARVO 2015 and carried in the IOVS abstract issue (Terry MA, Alshaarawy AM [Dr. Ahmed Shaarawy], Sales CS, Mayko ZM, Straiko MD), studying which surgical and patient factors predict re-bubble rates after DMEK. It is a meeting abstract, not a full peer-reviewed article, so it carries no volume, pages or PMID. We do not publish an audited re-bubble rate of our own, so we will not quote one. What we can tell you is that when it is needed it is done in clinic under topical anesthesia, with no return to the operating room.

Related reading

Corneal scarring: causes, treatment, and restoring vision →Corneal scar treatment: laser, DALK or transplant →Corneal transplant cost in Egypt →

Book your consultation

Pick a day and time. The first visit is an eye exam with Dr. Ahmed Shaarawy, who tells you which option suits your eyes.

Discuss your case with the surgeon who introduced S-DMEK in Egypt.

Send your specular microscopy, OCT, and recent topography. We'll respond within 24 hours with whether DMEK, DSAEK, or another approach is right for you, the all-in cost, and a recommended travel plan.

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Medical references

  1. Hos D, Tuac O, Schaub F, 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 2.3% at four years.
  2. Anshu A, Price MO, Price FW Jr. "Risk of corneal transplant rejection significantly reduced with Descemet's membrane endothelial keratoplasty." Ophthalmology. 2012;119(3):536-540. PMID: 22218143. rejection risk after DMEK significantly lower than after DSEK or penetrating keratoplasty.
  3. Dr. Ahmed Shaarawy: 20+ years of corneal and refractive surgery, Devers Eye Institute fellowship (Portland, Oregon), two surgical techniques in the AAO video library. The figures on this page come from the published literature, not from this clinic's own patients.
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