Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK)

DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) is a form of corneal transplant surgery. It is indicated for corneal swelling caused by:

  • Fuchs Dystrophy
  • Decompensated endothelium (back of cornea)

The cornea has five layers. In DSAEK the innermost layer (closest to the inside of the eye) is removed. An automated dissector harvests a thin piece of donor tissue that is then placed into the operative eye. It is secured to the cornea by an air bubble. Two or three stitches may be needed to close the initial incision.

In the operating room you receive anesthesia for relaxation and numbing medicine behind the operative eye. Surgery typically lasts 45 to 60 minutes. At the end of the procedure you stay lying on your back for another 40 minutes. At that point the surgeon examines your eye to ensure proper placement of the tissue, as well as check the eye pressure. You are then sent home with an eye patch.

You will be directed to use eye drops frequently after the surgery. These are typically reduced at an appropriate time period following surgery.

Visual recovery varies with each patient but usually takes three to six weeks. You may need an alteration in your glasses or contact lenses to enhance your vision during this time.

Potential benefits of DSAEK include (but are not limited to):

  • Improved vision
  • Less recovery time compared to standard corneal transplantation
  • Less astigmatism compared to standard corneal transplantation
  • Reduced discomfort compared to before surgery
  • Improved functioning in daily activities

Potential risks of DSAEK include (but are not limited to):

  • Dislocation of transplanted tissue (typically repositioned with an air bubble)

Alternatives to DSAEK include:

  • Standard corneal transplant (all five layers transplanted)
  • No surgery
  • Bandage contact lens