This is a video of a corneal transplant technique for endothelial dysfunction such as Fuch’s corneal dystrophy or pseudophakic bullous keratopathy combined with cataract surgery. The video displays techniques for determining correct graft orientation including a novel S stamp technique. The surgery is performed by Dr. Michael Straiko at Devers Eye Institute / Legacy Good Samaritan Hospital. The type of transplant in this video is a DMEK (Descemet’s Membrane Endothelial Keratoplasty). In this type of transplant only the dysfunctional inner layers of the cornea are replaced. This technique allows for a safer surgery and a more rapid recovery than conventional transplants. This is the latest iteration of endothelial keratoplasty. The first endothelial keratoplasty in the United States was completed here at the Devers Eye Institute in March of 2000 when Dr .Mark A Terry completed his first DLEK (Deep Lamellar Endothelial Keratoplasty) in Portland Oregon.