A special type of corneal transplantation is a partial transplant of just the back portion of the cornea called DSEK. DSEK removes the diseased innermost corneal membrane that is then replaced by a healthy donor transplant. DSEK here at Morristown Ophthalmology Associates, P.A is state-of-the-art and offers several benefits over other methods of corneal transplants . DSEK is less invasive and leaves the eye stronger and less prone to injury than full-thickness transplants. Additionally, DSEK has a more rapid rate of visual recovery. Vision is typically restored in a matter of weeks rather than over many months.
The cornea is composed of five layers, and to see well, all layers must be free of any cloudy or opaque areas. By remaining transparent, the cornea retains its ability to refract light properly.
The endothelium is the extremely thin, innermost layer of the cornea, and healthy endothelial cells are required to keep the cornea clear. Fluid naturally seeps from the inside of the eye into the middle corneal layer (also called the stroma), and the endothelium’s primary task is to pump excess fluid back out. Without this pumping action, the stroma would swell with water, become initially hazy and then ultimately opaque. In a healthy eye, a perfect balance is maintained between the fluid moving into the cornea and fluid being pumped out of the cornea.
Once endothelial cells are destroyed by disease or trauma, they are lost forever. If too many endothelial cells are destroyed, corneal edema occurs, which in turn causes a decrease in vision.
The DSEK Procedure
First, the patient’s endothelial layer is removed from the rest of the cornea. Then the donor endothelium attached to a thin layer of donor cornea is folded and inserted through a small incision. An air bubble is injected to push the donor cornea up against the posterior surface of the patient’s cornea. The pumping action of the new donor endothelium helps bond the donor tissue to the patient’s own cornea.
Like any corneal transplant procedure there is still some risk of infection or rejection of the new donor tissue, so taking your medications properly and careful follow-up examinations are important.