Current evidence shows that very thin endothelial keratoplasty (EK) grafts provide better visual results and fewer refractive surprises. Descemet membrane endothelial keratoplasty (DMEK) donor grafts will remain the thinnest grafts available until surgeons are able to transplant just endothelial cells or circumvent the need for donor tissue by stimulating the patient’s own endothelial cells to regenerate. In this presentation, Dr. Frank Price discusses his own transition from Descemet-stripping endothelial keratoplasty (DSEK) to DMEK and why the additional surgical challenge is worth the steep learning curve.