DSEK (Descemet Stripping Endothelial Keratoplasty) and DSAEK (Descemet Stripping Automated Endothelial Keratoplasty) are both methods of endothelial transplantation. These small incision techniques selectively transplant the underside of the cornea.
Both DSEK and DSAEK involve replacing some of the defective inner layers of the cornea with healthy donated tissue. Both have a relatively small incision size when compared to traditional cornea transplants and offer a much lower risk of astigmatism.
Endothelial transplantation (DSEK and DSAEK) provides the potential of rapid visual recovery while still maintaining the structural integrity of the patient’s eye. Frequently, two or fewer sutures are used during the entire procedure. The long-term risk of eye rupture from trauma is also much lower with this procedure than with traditional cornea transplants.
The Procedures – In Detail
A complete preoperative evaluation is required prior to corneal DSEK and DSAEK, and every attempt to confirm retinal and optic nerve function is made prior to the procedure.
The majority of adult patients have surgery under IV anesthesia. General anesthesia is often required for children, anxious, or complex patients. After the anesthetic is given, the defective tissue is removed and the donor tissue inserted. An air bubble holds the donor tissue in place so that it can attach to the patient’s own cornea. This air bubble usually disappears 1-2 days after surgery. For the first 1-2 hours after surgery, it is important that the patient lies on his/her back to help the new tissue adhere to the cornea.
Postoperatively, patients should expect a very gradual recovery of vision. In fact, the best vision may not be obtained for six to 12 months or more following surgery. Patients are usually able to return to normal activities within a few weeks following surgery.
Saving Corneal Transplant SurgeryView Document
Visian ICL Injector for DSAEK
Notice: This is an actual eye surgery. Donor is injected without compression. This has been described by Korean doctors (ASCRS 2009), and this device has been used in DMEK for an even longer period.