DSAEK (Descemet Stripping Endothelial Keratoplasty) Sutureless Corneal Endothelial Transplant
For the treatment of corneal swelling, DSAEK is a way of performing a safer corneal transplant than traditional Penetrating Keratoplasty (PKP). Only the damaged endothelial layer is replaced, leaving the remainder of the cornea undisturbed. In a traditional transplant of the cornea a full thickness incision is made, creating a circular opening in the front of the eye that requires many sutures to secure the transplant. In DSAEK the new cornea is inserted through a small incision that requires one suture for closure; the graft is then supported by an air bubble until it stabilizes.
Because the new transplant does not require sutures, there is less induced irregularity or change in the curvature of the recipient cornea (astigmatism). This translates into faster rehabilitation of vision, fewer postoperative physical restrictions and a stronger eye after surgery which is less susceptible to injury from trauma. The surgical incision is smaller and does not greatly alter the eye’s integrity. There is also less concern about sutures breaking and causing infections.
What is corneal swelling?
Swelling of the cornea can result from premature aging of the cornea’s inner lining (Fuch’s Endothelial Dystrophy) which is a hereditary condition, or as a result of loss of these inner cells (endothelium) due to trauma, including previous eye surgery. This is where DSAEK can be most helpful in restoring vision. DSAEK does not work in scarred or irregularly shaped corneas.
Donor Corneas- Where do they come from?
Losing a loved one is undoubtedly devastating; a donated cornea from a healthy eye is a gift of sight that lives on.”Donor” refers to the person providing the cornea;”recipient” is the person receiving the cornea. There is no need to match the tissue, eye color or gender for corneal transplants. We usually do attempt to match the general age, especially when operating on a child or young adult, as these individuals have much longer life expectancy. It is a common misconception that, when donating the corneas, the body will be disfigured. This is not true. Only a portion of the cornea the size of a dime is donated.
How is DSAEK Done?
The surgery is performed under mild sedation. Numbing medication is also used so there is little or no discomfort. Using sophisticated instrumentation adapted from LASIK procedures, the donor cornea is prepared and placed in the recipient’s eye. This new graft is then supported by an air bubble that presses against the recipient’s cornea while the patient is comfortably lying on their back. The bubble takes the place of sutures and is only necessary for a short period of time after completion of the surgery.
Advantages of DSAEK:
- Visual recovery is significantly faster.
- The eye is less susceptible to injury after surgery.
- There is usually less astigmatism and less change in your eyeglass prescription.
- Suture related problems are reduced.
- There are fewer restrictions on physical activity after the surgery.