DSEK

DSEK – Descemet's Stripping Endothelial Keratoplasty - is a new option for patients with corneal edema who require corneal transplantation. This is a sutureless corneal transplant that has several advantages over traditional corneal transplant surgery which include:

• Faster visual recovery
• Less astigmatism created since there are no sutures
• Eye is much stronger and more resistant to injury since only the diseased tissue rather than the entire cornea is replaced
• Surgery time is quicker
• Chance of rejection is reduced significantly
• Procedure can be combined with cataract surgery

In order to understand this new procedure one must understand the conditions and pathology that lead to corneal edema.

The back cellular layer or posterior layer of the cornea is called the endothelium and is responsible for maintaining the clarity of the cornea by pumping excess fluid from the cornea. The endothelium has a finite number of cells; that is these cells are unable to be replaced once they are damaged or die. Certain conditions can cause loss of these finite cells (endothelial cell loss) leading to corneal edema and vision loss. Irreversible corneal edema occurs when the endothelial cell loss occurs to such an extent that fluid is no longer able to be pumped from the cornea and the cornea swells preventing light from being focused on the retina.