Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK)

Madison Corneal Surgery Options

Have you heard about a new corneal transplant procedure called DSAEK? DSAEK is a corneal surgery procedure for severe corneal disease or 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 replaced damaged or disease corneas. Both the conventional corneal transplant technique and DSAEK require use of a donor cornea, but DSAEK replaces only the damaged posterior section ofyour cornea. This procedure, which requires minimal suturing,allows more rapid visual restoration, less discomfort, and a reduced risk of sight-threatening complications.

What happens in DSAEK cornea surgery?

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 Anderson &Shapiro Eye Care so that our doctors can best determine the patient’s treatment options, including the need for DSAEK surgery. One week prior to surgery the staff at Anderson &Shapiro Eye Care begins the process of procuring donor corneal tissue in preparation for the patient’s DSAEK surgery and schedules all appropriate operating room time at the surgical facility.

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. The patient will need to go home the day of surgery and remain on their back until their follow-up appointment the next day. 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.

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