This is a video a corneal transplant technique for endothelial dysfunction such as Fuch’s corneal dystrophy. The video emphasizes pearls for successful DMEK surgery combined with cataract surgery. In this video, we see the DMEK technique applied to both eyes of one patient. This highlights how differently DMEK grafts can behave, even in the same patient. The surgeries are being performed by Dr. Michael Straiko at Devers Eye Institute / Legacy Good Samaritan Hospital in Portland Oregon. 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. In this narrated video Dr. Straiko is using a novel injector system to insert the tissue and providing some pearls on successful surgery with two very different grafts.