Title : Understanding the basics of DSAEK
Abstract:
Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) is a posterior lamellar keratoplasty technique that specifically targets corneal endothelial dysfunction. It involves replacing the recipient's diseased or dysfunctional endothelium with a thin donor corneal graft consisting of the Descemet membrane and endothelium. The procedure begins with the creation of a partial-thickness stromal pocket or tunnel in the recipient cornea. The donor cornea is prepared by manual or automated stripping the Descemet membrane and endothelium, which is then inserted into the recipient's eye through the prepared tunnel. ]The graft is held in place using an air or fluid bubble. DSAEK offers advantages over PKP by preserving the recipient's anterior corneal integrity, resulting in faster visual recovery and reduced astigmatism. DSAEK has become a popular choice for treating corneal endothelial dysfunction, including conditions such as Fuchs' endothelial corneal dystrophy and pseudophakic bullous keratopathy. It has shown excellent graft survival rates and improved visual outcomes. However, DSAEK is associated with potential complications, such as graft dislocation, interface haze, and endothelial cell loss. Advances in instrumentation and surgical techniques, such as pre-cut donor grafts and the use of femtosecond lasers, have further refined DSAEK and improved surgical outcomes.
