The cornea is the clear tissue at the front of the eye that focuses light as it passes through. This part of the eye is made of layers of cells, each of which works to bend light into a uniform beam that will land on the retina. For the cornea to achieve clear vision, it must be clear. If an injury or damage occurs, light cannot be focused properly through the eye. As a result, you may see glares or have blurry vision. When a corneal injury is too severe to be repaired, it may be necessary to replace the tissue with a corneal transplant.
What are Corneal Transplants?
A corneal transplant is a healthy cornea that comes from a human donor who has elected to donate their corneas after their death. The donated tissue is treated with the utmost care and is thoroughly tested to ensure the highest degree of safety. Corneal transplant surgery is performed in a few different ways. Here at Wilkinson Eye Center, our doctors perform the DSAEK procedure. DSAEK, Descemet’s Stripping (Automated) Endothelial Keratoplasty, is a type of endothelial keratoplasty. This type of corneal transplant focuses on replacing an isolated section of the endothelium, the innermost layer of the cornea. Damage to this layer of cells can cause swelling that negatively affects vision. The partial replacement of affected tissue can restore the crispness and clarity that have been lacking.
Who is an Ideal Candidate for DSAEK Corneal Transplant?
The DSAEK procedure may be ideal for people who have sustained damage or have a defect in the inner layer of the cornea. The most common condition treated with this procedure is Fuchs’ Corneal Dystrophy. This inherited eye disease causes the cornea to swell and become cloudy.
What are the Benefits of DSAEK?
While there are instances in which full corneal transplant surgery is necessary, such as corneal scarring, DSAEK offers unique benefits for qualified patients. The standard corneal transplant, Penetrating Keratoplasty or PK, is more involved and invasive because it replaces the entire cornea. DSAEK replaces only the portion of the innermost layer of corneal tissue that is diseased or damaged. That inner layer, the endothelium, can be removed without disruption to the other layers of the cornea. Because there is no full-thickness incision made during the DSAEK procedure, only a single suture is placed. The advanced technique is more conservative, so usually incurs a shorter recovery period. Patients’ vision may return faster after this procedure than a full corneal transplant, and they have a lower risk of rejection of the graft tissue.
The DSAEK Corneal Transplant Procedure
Before the DSAEK procedure, the doctor may prescribe eye drops and antibiotics. Other pre-operative instructions may also be provided. These should be carefully followed. The surgery is usually performed on an outpatient basis using numbing medication and mild sedation. Patients experience little to no discomfort after the anesthetic eye drops are administered. The doctor uses sophisticated instruments that are similar to those used in LASIK procedures to access the endothelium of the cornea. They remove a select portion of the Descemet membrane and endothelium to eliminate the diseased or damaged area, then replace it with the donor corneal graft. The new corneal tissue is supported by an air bubble, which compresses the tissue against the rest of the cornea while it heals.
Recovery and Aftercare for DSAEK Procedure
The air bubble inserted into the eye only compresses the cornea when the patient is lying on their back. Once home after surgery, the patient must lie flat on their back for at least 24 hours after the procedure. They may get up to eat and use the bathroom but should otherwise remain flat as much as possible until returning to the office the next day for their follow-up. At the follow-up, we do not expect vision to be vastly improved. Initially, vision may appear worse before it begins to adjust over about two weeks. Vision can continue to get better for up to six weeks following treatment. Patients can expect some light sensitivity and a scratchy sensation in the eye. Post-operative pain should be minimal. Most normal activities may resume after one week, including wearing eye makeup. While light exercise is acceptable, patients should not swim and should avoid intense exercise like weight lifting for approximately four weeks.
Schedule Your Consultation
Wilkinson Eye Center has been providing outstanding ophthalmic care in Oakland County for more than 40 years. If you would like to learn more about DSAEK corneal transplant surgery, please contact us at (248) 334-4931 for an appointment in our Pontiac, MI office. Call (248) 625-5922 to schedule a visit to our Clarkston, MI office.