Descemet's Stripping Endothelial Keratoplasty (DSEK)

The aim of Descemet's stripping endothelial keratoplasty (DSEK), is to replace only the endothelium (innermost layer of the cornea), rather than the entire thickness of the cornea. For patients who have conditions such as Fuchs’ endothelial dystrophy or swelling of the cornea after cataract surgery, corneal clouding is caused by a decrease in number of the endothelial cells, whose function is to pump fluid out of the cornea.

DSEK involves peeling only the diseased endothelial layer from the back of the patient's cornea, leaving the remaining 95% of the cornea, which is healthy, untouched. The back layer of a healthy donor cornea is then placed inside the eye through a small incision and positioned with an air bubble to replace the diseased layer that was removed. After the surgery a patch will be place on the eye and the patients should try to lie down on the back, facing the ceiling as much as possible for the first 24 hours, until seen back the next day.

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 patient's cornea is essentially intact
• Suture-related problems can be eliminated
• Visual recovery is significantly faster and better
• DSEK offers patients better visual recovery and a less protracted clinical course than standard corneal transplantation.