DSAEK, or Descemet's Stripping Automated Endothelial Keratoplasty, is a newer technology in the world of corneal transplantation. It allows only the damaged endothelial layer of the cornea to be removed. The primary population for this type of procedure is those who suffer from the corneal disease Fuchs’ Dystrophy. During a DSAEK procedure, the damaged endothelial layer is stripped away and replaced with a thin back portion of tissue from a donor cornea. Instead of replacing the entire cornea, this allows for the replacement of only the damaged tissue. According to Dr. Ravi Shah, Corneal and Refractive Surgeon at Eyecare Medical Group, DSAEK has a lot of advantages over the traditional method of corneal transplantation.
“There’s a lot more wound stability with a DSAEK because there is less trauma to the eye. DSAEK has a quicker post op healing time than a PK, and there is less post surgical astigmatism than with a PK because of the lack of sutures.” DSAEK does have some disadvantages- a bubble has to be placed in the anterior chamber to hold the donor graft, and if the graft becomes dislodged, another surgery to place a new air bubble may be required. It can also be difficult to get the endothelium off of the donor cornea. If the donor cornea is damaged, there is a higher chance of rejection.
Not all patients who require a corneal transplant are candidates for a DSAEK procedure. The conventional full thickness graft, or penetrating keratoplasty, may be required depending on what disease is present and what area of the cornea is damaged.