DSAEK

A DSAEK procedure is a partial-thickness corneal transplant that replaces only the innermost layers of the cornea called the endothelium and posterior stroma. A thin piece of donor tissue is inserted on the back surface of the patient’s cornea. The technique is a significant improvement over a standard full thickness corneal transplant.

There are several advantages to DSAEK operation compared to standard corneal transplant surgery. The surgery itself takes less time with an experienced surgeon. The wound is smaller, more stable and less likely to break open from trauma. Because the wound is smaller and requires far fewer sutures, there is very little postoperative astigmatism which can delay the visual recovery. The maximum return in vision takes only about 3 to 4 months following DSAEK. Since only the thin layer of the cornea is replaced, over 90% of the patient’s own cornea remains behind, contributing to greater structural integrity and may reduce the incidence of rejection.

There is a risk of the thin button of cornea becoming displaced within the first few days or weeks after surgery and requiring a return trip to the operating room to reposition it. If the DSAEK operation fails, the operation can be repeated with another corneal button. If the DSAEK fails, either after one or multiple attempts, a traditional corneal transplant operation can be performed.

Only patients with endothelial cell problems are candidates for DSAEK. Patients with corneal scarring or other conditions will still require the full-thickness procedure.

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