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The cornea refers to the transparent and outermost layer of the eye. The purpose of the cornea is to focus the vision for greater visual acuity. Unlike most tissues in the eye, the cornea does not have blood vessels for nourishment or protection. Therefore, physicians regard the cornea as a very sensitive tissue. While the cornea is very susceptible to both damage and disease, there are permanent solutions for those afflicted with an eye condition related to the cornea.

Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK)

DSAEK surgery is a method used by surgeons to permanently fix a damaged or diseased cornea. In fact, physicians regard the DSAEK procedure as the “gold standard” for the surgical treatment of the cornea, according to Medscape. Prior to the development of the DSAEK procedure, patients with cornea damage or disease would undergo conventional corneal transplant. Some of the advantages the DSAEK surgery holds over the conventional corneal transplant include:

  • Faster visual recovery and rehabilitation
  • Lack of sutures in the surface of the corneal
  • Less induced astigmatism
  • More stability in the ocular surface and globe

How is DSAEK Surgery Performed?

A surgeon will perform DSAEK surgery by creating a tiny incision from the cornea’s temporal side. The location of this incision will give the surgeon excellent visualization and manual access. The surgeon will create another two corneal incisions to serve as access points to the eye’s anterior chamber.

One portion of the DSAEK procedure involves the Descemet’s stripping. For this portion of the procedure, the surgeon will use a reverse Sinskey hook. The surgeon will puncture the thickened Descemet’s membrane and the diseased endothelium with the reverse Sinskey hook. This hook will completely strip away the Descemet’s membrane so that the surgeon can remove the diseased tissue from the anterior chamber of the cornea.

The donor tissue, which was prepared prior to the surgery, is folded with special folding forceps. The surgeon will implant the folded donor tissue into the anterior chamber. The surgeon will then remove any fluid within the eye and manipulate the donor tissue to center it in the eye. Finally, the surgeon will fill the anterior chamber with air so that the pressure will help the donor tissue adhere to the cornea.

A damaged or diseased cornea can have devastating consequences for one’s vision. Fortunately, the DSAEK procedure is an excellent and permanent solution for patients who need a corneal transplant. For more information about how to permanently fix a damaged or diseased cornea, contact us here at the Southwestern Eye Center.