Descemet's Stripping Automated Endothelial Keratoplasty
DSAEK is a new procedure that can help some patients who previously would have required a full thickness corneal transplant (Penetrating Keratoplasty). As with a full thickness transplant, DSAEK also requires the use of a donor cornea. Instead of replacing the whole cornea, DSAEK replaces only the diseased posterior section of the cornea. DSAEK requires minimum sutures, allows a faster visual recovery, less discomfort and reduces the risk of sight threatening complications.
The cornea is the clear portion of the front of the eye. It helps bend and focus light on the retina at the back of the eye. In order for vision to be clear, the cornea must be clean and clear. Corneal disease can cause the cornea to become cloudy, preventing light from passing through clearly.
What to expect the day of surgery.
You will be asked to arrive 30 minutes to one hour prior to surgery. You will be checked in and given a sedative to relax you. You will then be prepared for surgery. Once the eye is numb a sterile drape will be placed, and an eyelid holder (speculum) will be placed to hold the eye open for the doctor during surgery. A small incision will be made so the surgeon can strip away the diseased Descemet’s membrane and endothelial cells. Next, the bottom 10 – 20% of a donor cornea with healthy Descemet’s membrane and endothelial cells will be inserted through the incision. After the donor graft is placed an air bubble will be used to hold the new portion of cornea in place.
Immediately following the surgery you will be taken to the recovery area where you will remain flat for about an hour to allow the air bubble to continue to press the tissue into place. Before you leave a patch will be placed over the eye. Antibiotic eye drops will be used for a week or so to help prevent infection. A mild steroid eye drop will be used for at least a year to help prevent rejection.
The day after surgery you should be able to resume your normal activities. DSAEK allows your vision to improve within a few weeks compared to a full thickness transplant which could take months or years. This allows the doctor to do DSAEK on the other eye within months instead of a year or more.
The goal of any vision restoration procedure is to improve your vision. Usually most patients will begin seeing better within 6-8 weeks. However, we cannot guarantee that you will have the results you desire. As with any transplant there is a risk of rejection of the donor tissue. If rejection does occur it is possible to have the procedure repeated.