The point is if you are watercooling the chances are your airflow in the case will be lower than an aircooled case (normally) so the memory will not have as much air flowing around them to dissipate the heat.
The EK blocks are nice. Less case heat but more heat dump into the loop. More expensive to replace at upgrade time too.
2 D-Tek Fusions cost £60 and can be used on other cards.
Going by the poor quality tim pads used im not so sure, all i can go on are my personal results. I do however make sure i have decent case cooling even though my CPU/GPU/NB are all WCed.The point is if you are watercooling the chances are your airflow in the case will be lower than an aircooled case (normally) so the memory will not have as much air flowing around them to dissipate the heat.
My view is that if nvidia see fit to cool the memory then there must be a reason for it.
Yes, use ramsinks. If the card is with or without them as standard you will lose the airflow from the air cooler when you go with water. Manufacturers do include the cooling effect, and even engineer it in, when designing cards, whether they have ramsinks or not.
How effective they are will depend on your setup.
I'm lucky, since I modded (am modding) a case I set it up so that the front 120mm intake blows directly at the graphics card, with nothing in between, enhancing the effect of the el cheapo sinks I used.