Descemet’s Stripping Endothelial Keratoplasty (DSEK) is one of the more recent techniques in corneal transplantation. A DSEK procedure is a partial-thickness corneal transplant that replaces only the endothelial layer. This advanced technique, where appropriate, is a significant improvement over the standard corneal transplantation operation. The surgery itself takes less time with an experienced eye surgeon, involves a smaller surgical incision, requires far fewer stitches, heals faster and more reliably, and the vision returns faster.
DSEK Benefits
There are several advantages to the DSEK operation compared to standard corneal transplant surgery. Since only the thin inner layer of the cornea is replaced, over 90% of the patient’s own cornea remains behind contributing to greater structural integrity and may reduce the incidence of rejection. The smaller incision offers several benefits over traditional methods of corneal transplant such as Penetrating Keratoplasty (PKP). Because the procedure is less invasive, DSEK leaves the eye much stronger and less prone to injury than full-thickness transplants. Additionally, DSEK has a more rapid rate of visual recovery. Vision is typically restored in one to three months rather than one to two years.
Who are candidates for DSEK?
Only patients with endothelial cell problems are candidates for DSEK. Patients with corneal scarring or other conditions will still require the full-thickness corneal transplantation procedure. There is a risk of the thin button of endothelium becoming displaced within the first few days or weeks after surgery and requiring a return trip to the operating room to reposition it, or the operation can be repeated with another button of donor endothelium. If the DSEK fails, either after one or multiple attempts, a traditional corneal transplant operation can still be performed.
