For patients with tissue broken down in the cornea, DSAEK can be an outstanding option in achieving better ocular health. Previously, patients would need a full corneal transplant for any damage to one of the three layers of tissue in the cornea. With advanced DSAEK, patients can receive a transplant to only the affected layer of tissue, allowing for less trauma to the eye, and better recovery.
There are three layers to the cornea. There's the surface epithelial layer, there's a central stromal layer, and finally there's the endothelial layer, which is the inner-most layer of the cornea. And in DSAEK what we do is we replace only that layer of tissue with a human donor button of the exact same tissue. So it's a lamellar transplant, meaning we're only replacing one layer of the cornea.
Previously when that tissue broke down, we would have to do a full-thickness Penetrating Keratoplasty, which is a full corneal transplant. And now we don't have to do that. We can replace only the inner-most layer of cells that aren't working. So the recovery in a procedure like that is much faster and the visual recovery is much faster as well. And the patients have must less pain, irritation, post-op complications, and a much easier post-op course.
A good candidate for DSAEK is someone who has only dysfunction of that inner-most endothelial layer of cells. Anyone who has scarring in the cornea that's blocking the vision or regular astigmatism is probably not a great candidate for DSAEK but the vast majority of patients are good candidates and that's why the procedure has overtaken full-thickness corneal transplant in this country.