A corneal transplant involves the removal of the damaged cornea and replacing it with a donor cornea. Modern-day corneal transplantation has evolved significantly. If only the top layers of the cornea are damaged, your surgeon will transplant only the upper layers. This results in lower rejection rates, improved stability and better vision. The endothelium is the deepest layer of the cornea. Your surgeon can perform a procedure called DSEK where this thin layer is removed and replaced with donor tissue. Unfortunately, in some cases the entire cornea may need to be replaced with a full thickness corneal graft.