DSAEK

DSAEK - Descemet's Stripping Automated Endothelial Keratoplasty

Have you heard about a new corneal transplant procedure called DSAEK? DSAEK is a corneal surgery procedure for severe cases or corneal disease or for damaged corneas. If you are not familiar with the cornea, it is a remarkable structure that helps to focus light and protect the internal structures of the eye. The shape of the cornea is important to the focusing of light on the retina in the back of the eye. A properly shaped cornea and healthy lens will allow this light to focus clearly, providing crisp vision. It is also important that the cornea remain clear so the light can pass through to the retina without being interrupted. If the cornea gets hazy or cloudy, or if the shape of the cornea becomes irregular, vision can be impaired. Some causes of this include age, trauma or disease. When vision is impaired enough to affect a patient’s daily functioning, it may need to be totally or partially replaced by a corneal transplant procedure.

DSAEK is a relatively new, but well tested corneal surgery technique that can help some patients who previously required a full thickness corneal transplant. The procedure is similar to the traditional cornea transplant because both use donor corneas to replace damaged or diseased corneas. The difference is that DSAEK replaces only the damaged posterior section of the cornea, rather than the entire cornea in a traditional corneal transplant. This procedure, which requires minimal suturing,allows more rapid visual restoration, less discomfort, and a reduced risk of sight-threatening complications.

Fuchs’ Dystrophy patients are the primary group of patients needing a DSAEK procedure. Fuchs’ endothelial dystrophy (FED) is a degenerative disorder of the corneal endothelium leading to corneal edema and loss of vision. Patients first receive a full evaluation and testing at the Texas Eye Institute so our doctors can best determine the patient’s treatment options, including the need for DSAEK surgery. 

What Happens in DSAEK Cornea Surgery?

On the day of surgery, the patient will arrive at the surgery center approximately one hour prior to surgery for preparation. The patient must not eat anything after midnight the day before surgery and will begin pre-operative medications three days prior to surgery as instructed. Prior to the patient’s surgery the surgeon will prepare for surgery by determining the type of tissue to be used and selecting the technique needed to ensure the best surgical outcomes possible. After the approximately one hour surgery, the patient must lie flat on their back so the air can push up into the cornea and hold the new tissue in position. Once the tissue sticks to the cornea, it will begin to function and pump the water out of the cornea, clearing vision. Vision improves fairly rapidly, with final visual results obtained in approximately 1-6 months after surgery.

After Your DSAEK Surgery

Shortly after the procedure,you will be taken into the Texas Eye Institute surgical recovery area where you will lie down with your eye looking up at the ceiling for about an hour to let the air bubble used to hold the transplanted tissue in the correct position to seal it securely in place. After the surgery your eye will be covered with a protective shield. Antibiotic eye drops will be used for a few weeks to help prevent infection, and a mild steroid eye drop will need to be used to help with healing and to reduce the risk of transplant rejection. Over the next 72 hours the surgeons at the Texas Eye Institute suggest resting on your back as much as possible. Our patients can typically resume normal activities 2 days after surgery.