Descemet's Stripping Endothelial Keratoplasty!
-In DSEK: the patient’s Descemet membrane is peeled off and replaced with a partial thickness graft: a transplanted disc of Posterior Stroma, Descemet and Endothelium. Both donor and host cornea are manually dissected.
-In DSAEK: the donor dissection is carried out using a mechanical microkeratome.
GOAL of DSEK:
-To transplant a healthy endothelial cell layer that will pump the fluid out of the cornea.
-Expected to restore corneal clarity and improve vision.
INDICATIONS:
-Bullous keratopathy (Pseudophakic & Aphakic).
-Fuch's endothelial dystrophy.
-ICE syndrome.
ADVANTAGES:
-Increase overall donor tissue availability, using the posterior layer of the donor cornea in one patient and the anterior lamellar graft in another patient.
-Faster to learn.
ADVANTAGES OVER PK:
-Smaller incisions.
-No corneal-graft sutures.
-Faster visual recovery.
-Less risk of sight threating complications and less induced astigmatism.
-Less risk of immune rejection of the transplanted corneal tissue.
-Shorter post-operative care.
www.ophthalmobytes.com
Image from Rajan Eye Care Hospital