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Background and Objective: Descemet membrane endothelial keratoplasty (DMEK) has increased in popularity since its introduction over 10 years ago. This article presents a summary of the experiences of the past years collected at the Department of Ophthalmology at the University of Cologne., Methods: A literature review of DMEK studies primarily from the Department of Ophthalmology at the University of Cologne, Germany was carried out. Own experiences in the fields of donor selection and graft preparation, DMEK surgery, complication management and postoperative treatment are summarized., Results: Since the introduction of DMEK experience has been gained and ongoing improvements have occurred ranging from donor-recipient allocation to postoperative follow-up. These led to a better reproducibility of the intervention for the surgeon, to a better postoperative result and to a reduction of the complication rate., Discussion: The DMEK represents a safe and individualized procedure for endothelial transplantation for corneal endothelial dysfunction. Continuing development of the method leads to optimization and safer results.

Physicians in German university hospitals feel themselves confronted with a multiple workload due to patient care, teaching and research. Furthermore, this load is increased by administrative duties and conference trips; however, the framework conditions surrounding this multiple workload of patient care, research and teaching as well as administrative activities are becoming increasingly more difficult. In particular, there is very little free time for scientific activities. Research is therefore often carried out during leisure time. The path of the clinician scientist, a duo of scientiific and clinical activities, opens up many possibilities; however, the question arises whether the career path of a clinician scientist is even possible under the current conditions or whether this is an endangered "species". This article presents the problems but solutions and ideas are also developed for optimum organization of this multiple workload and to appreciate the additional value of clinician scientists.