What is a DSEK procedure for corneal transplant?

David R. Demartini, MD
Descemet's Stripping Endothelial Keratoplasty (DSEK) is a partial thickness corneal transplant that replaces the posterior layers of the cornea. This was developed to try to simplify the corneal transplant procedure and avoid some of the post-operative problems that arise after full thickness transplant (penetrating keratoplasty).
During DSEK, Descemet's membrane and the endothelium is stripped and removed from the back of the patient’s cornea and a new partial thickness wafer of the donor cornea is inserted in its place. A larger air bubble holds this new tissue in place until it sticks and adheres on its own. This new donor tissue than takes over for the diseased cornea and clears it for improved vision.
In the advanced DSEK procedure, a much smaller incision is used than in a traditional cornea transplant. Only a very thin layer (approximately 100 microns) of donor cornea is inserted into the eye. After the new endothelial cells are unfolded in the eye, an air bubble is placed in the front part of the eye to push the new cells up against the dome-shaped cornea.

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