DSAEK is an exciting new way to perform corneal transplants (please see the corneal transplant section for additional background material). This procedure works for patients whose corneas begin to cloud over due to endothelial dysfunction ( this surgery cannot be performed on a scarred cornea, or an irregularly shaped cornea). The endothelium is a layer of pump cells on the back surface of the cornea inside the eye. These cells pump fluid form the cornea to keep the tissue compact and clear. If the pump cells are not working the cornea swells and becomes cloudy. The most common cause for endothelial dysfunction is an inherited disease called FUCHS dystrophy. In DSAEK, instead of transplanting the full thickness cornea, only these diseased pump cells are replaced.

DSAEK uses the innovative instrumentation designed for LASIK. In this procedure the unhealthy pump cells are stripped off the back of the patient’s cornea. The donor tissue is then prepared using the LASIK instrumentation to create only a thin layer of tissue to transplant. This thin layer contains a new healthy layer of pump cells. The benefit of DSAEK is that the thin layer of tissue can be inserted through a very small incision similar to cataract surgery. The tissue adheres to the recipient cornea through the active pump mechanism, and does not require any sutures.

Because DSAEK requires less manipulation, the healing time is much quicker, there is less post-operative discomfort, and there is a limited change in the refractive error of the eye.

DSAEK is performed as an outpatient procedure under local anesthesia. The surgery takes about one half an hour. Post-operatively patients need to lie flat for one hour, to ensure that the tissue adheres properly. The tissue position is examined prior to discharge from the hospital. There is about a ten percent chance that the tissue will need to be repositioned in the first week after surgery. In the rare circumstance that DSAEK does not work, patients can still subsequently undergo regular corneal transplantation.

We have already performed many DSAEK transplants with excellent results.

Section 1: D - Scoring Descemets membrane ( the membrane that holds the pump cells)
Section 2:  S - Stripping Descemets membrane (removing the diseased pump cells)
Section 3: A - Automated preparation of the donor tissue.  (Using an advanced LASIK instrument to create a thin disc of donor pump cells.)
Section 4:  E - Inserting the endothelium ( new layer of pump cells)
Section 5:  K- Inserting air to postion the new tissue.  No sutures required. (Keratoplasty)