Request an Appointment: 503-413-8202

DSAEK Cornea Transplants

DISCLAIMER! The information on this website is general information. Please discuss with your surgical provider your concerns and questions about the procedure. Your personal health information may differ from the information presented here.

Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) is a selective form of corneal transplant that replaces an abnormal posterior corneal endothelium and Descemet membrane with a corneal donor tissue that includes the endothelium, Descemet membrane, and a small amount of corneal stromal tissue. DSAEK surgery is an excellent way to replace an ineffective endothelial layer, especially in patients who have risk factors that make Descemet Membrane Endothelial Keratoplasty (DMEK) less likely to succeed. DSAEK surgery has many advantages over penetrating keratoplasty, including a smaller incision that is more stable and less likely to cause irregularity of the cornea in the form of astigmatism, a lower risk of corneal transplant rejection, and a more rapid recovery of vision after surgery. DSAEK surgery starts with the creation of a stable scleral tunnel incision, the removal of the abnormal endothelium and Descemet membrane, and the placement of a precisely-sized donor tissue through the incision. The donor tissue is then lifted into position with an air bubble placed in the front of the eye. By using the air bubble to hold the transplant in place, the use of permanent sutures is usually not necessary. After surgery, patients remain in the recovery area lying flat in a face-up position to allow for the transplant to fully attach. The eye is patched overnight and patients are generally asked to lie on their backs in a face-up position until the next day. A careful examination is performed by the surgeon on the day after surgery. If there is detachment of the DSAEK transplant, a new air bubble may be placed in the eye either in the operating room or in the procedure room in the office. As the donor tissue clears fluid from the cornea, the vision will improve. Once the cornea is clear and stable, a new pair of spectacles or contact lenses can be prescribed for the sharpest vision. Full vision recovery tends to take 1-3 months, although slight improvement may be noted even 1-2 years after surgery. Steroid drops are taken for at least 1 year after surgery on a tapering schedule to reduce the risk of corneal transplant rejection. We ask all patients to be vigilant with regard to the symptoms of corneal transplant rejection, which can be remembered with the mnemonic “RSVP” Redness, Sensitivity to light, decreased Vision, and Pain.