Cornea Transplants
Penetrating Keratoplasty (PK)
Descemet’s Stripping Endothelial Keratoplasty (DSEK)
Deep Anterior Lamellar Keratoplasty (DALK)
Lamellar Keratoplasty
Artificial Cornea

Descemet’s Stripping Endothelial Keratoplasty (DSEK)

Descemet’s Stripping Endothelial Keratoplasty (DSEK) removes an abnormal back layer (endothelium) and replaces it with a thin layer of donor tissue (partial thickness transplant).  This procedure takes less time, uses a smaller incision, has no stitches in the transplant, has a faster recovery time, and the strength of the cornea remains more stable compared to a full-thickness transplant (penetrating keratoplasty).  If the pathology is limited to the posterior corneal layers, this surgery is prefered given its lower risk and quicker recovery.  The choice is like comparing open-heart surgery to a stent placement for heart vessel blockage.

The outpatient surgery usually takes 30 minutes. The eye is numb during the surgery and patients are sedated ("twilight sleep") during the procedure. After the graft is centered, an air bubble is placed in the anterior chamber of the eye to help the "hold" the graft securely in position.  The patient then lays flat in the recovery area to allow the bubble to "work" and give the graft time to adhere well.  The air bubble and eye pressure are adjusted by your doctor at the surgery center about  45-60 minutes after the procedure.  A patch and shield is placed on the eye and remains in place until the next day follow-up examination in the office.  Patients are asked to lay flat for 24-48 hours, as much as possible, to give the graft the best chance to remain attached.  There is approximately a 5% chance that the graft does not "take" the first time.  In most cases, a minor office procedure can be performed to reattach the graft without complication.  This partial thickness tranpslant can be repeated if necessary.  Patients do very well after this type of transplant. 

The surgery is an outpatient surgery. Eye drops help healing and prevent the risk of rejection and infection.  Vision recovery takes an average of 6 months.  Specific post-op instructions will be given at the time of surgical counseling and after surgery.  Risks are inherent to any surgical procedure.  Detailed risks, benefits and alternatives will be discussed thoroughly between each patient and the doctor at the time of consultation.

Each patient's eye is different. The description above may not apply to every individual situation. Your doctor will perform a full evaluation and discuss her findings thoroughly. A treatment regimen will be planned and re-evaluated throughout follow-up visits. Please contact your doctor if you feel you have dry eyes or if you have any concerns or questions regarding your ocular health. 

As cornea specialists in DFW, Dallas-Fort Worth, Dr. Koreishi and Dr. Ple-plakon strive to provide the best cornea care, availability, and patient education. Now open Plano Cornea.

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