Dr. Steven Fite is a Board Certified Ophthalmologist/Corneal Specialist
DSEK stands for Descement Stripping Endothelial Keratoplasty. It represents a major breakthrough in corneal transplantation and offers patients many advantages over traditional corneal transplant surgery. Patients who qualify for DSEK experience a much faster recovery, significantly less risk of tissue rejection and improved overall quality of vision.
What is Corneal Transplantation?
The cornea, the clear outer covering of the eye, allows light to pass through and focus on the retina, which allows you to see. Certain medical conditions, inherited disorders and injuries to the eye can cause the cornea to become scarred, swollen with fluid, cloudy or too thin. When that happens, light is prevented from reaching the retina. The only treatment to prevent vision loss is a corneal transplant, in which the patient’s damaged corneal tissue is removed and replaced with healthy corneal tissue that has been stored at a local eye bank after being donated by a human donor.
Corneal transplantations are among the most successful and commonly performed organ transplant procedures in the world. Every year, some 30,000 procedures are performed in the U.S.
How is DSEK different from a traditional corneal transplant?
In traditional corneal transplant surgery, the surgeon removes the entire damaged central portion of the patient’s cornea and replaces it with a donor cornea. This is called a full thickness penetrating corneal transplant. DSEK involves transplanting only one thin layer of corneal tissue, the endothelial layer. The remaining healthy layers of corneal tissues are kept intact.
What are the advantages of DSEK?
There are numerous benefits of DSEK for both the patient and the surgeon. The new procedure is faster and can be combined with cataract surgery. The potential for tissue rejection is greatly reduced since only a thin layer of corneal tissue is transplanted rather than a full thickness graft. In addition, traditional corneal transplantation requires a minimum of 16 stitches to close the incision, while DSEK takes only about three stitches, which retains the natural shape of the cornea and reduces suture-related complications. The eye remains much stronger and is less at risk for injury after DSEK.
Visual quality is improved, too. Patients regain their vision within approximately three months after DSEK compared with a full year or more for traditional corneal transplantation. Most DSEK patients will need only a minor adjustment to their prescription after the surgery and some may not need to wear glasses or contact lenses. In contrast, after traditional corneal transplantation, the vast majority of patients need to wear hard contact lenses or strong prescription lens glasses to restore their sight.
What types of patients qualify for DSEK?
DSEK is only performed when the patient’s endothelial layer is diseased or damaged.
The endothelial layer’s function is to keep the cornea clear by pumping out excess fluid in the tissues. But certain medical conditions or trauma can affect the endothelial cells, which allow a build-up of fluid to occur, causing corneal swelling and swelling, leading to vision loss. For those patients, DSEK offers a major breakthrough. Fuch’s Dystrophy and Pseudophakic Bullous Keratopathy are two examples of eye conditions that can benefit from DSEK transplantation.
For more information about corneal transplantation and whether you might qualify for the new DSEK procedure, please contact Fite Eye Center at 586-765-0775.