DSEK: The Partial Corneal Transplant
If a cornea has become diseased or has become irregular, the vision will be impaired. To repair vision, the cornea will need to be replaced with either a new cornea in a corneal transplant called Penetrating Keratoplasty (PKP) or partially replaced by a procedure known as Descemet’s Stripping Endothelial Keratoplasty or DSEK.
Some disease like forms of Fuch’s Dystrophy and select cases of corneal swelling after eye surgery, are due to dysfunction of the cornea’s cells. This layer of cells, called the endothelium, can be replaced surgically with DSEK. With DSEK, the bottom layer of the cornea is removed and replaced with a small disc of cells from a donor. The replacement of the malfunctioning endothelial cells allows the cornea to once again become clear. DSEK is performed through small incisions and has a relatively fast recovery period. Usually, the cornea can be greatly cleared by 4 to 6 weeks after the procedure.
Like PKP, DSEK is a corneal transplant procedure, so a lifetime of eye drops and eye examinations are needed afterward.
Advantages of DSEK as compared to standard corneal transplantation are:
- The eye is left much stronger and more resistant to injury
- There is minimal change in refractive error because the cornea is essentially intact
- Suture-related problems can be eliminated
- Visual recovery is significantly faster and better
DSEK is specifically suited for patients who have posterior corneal diseases with endothelial dysfunction. Patients with corneal conditions such as Fuch’s dystrophy, bullous keratopathy or failed prior corneal transplants are surgical candidates who may benefit from the DSEK cornea surgery.