A DSAEK procedure is a partial-thickness corneal transplant that replaces only the inner portion of the cornea containing the endothelial layer. A thin piece of donor tissue is inserted onto the back (inner) surface of the patient’s cornea. involves a smaller surgical incision, requires far fewer stitches, heals faster and more reliably, and the vision returns faster.

There are several advantages to the DSAEK operation compared to standard corneal transplant surgery. The surgery itself takes less time when performed by an experienced physician. The wound is smaller and closer in size and location to a cataract surgery incision. The smaller wound is more stable and less likely to break open from trauma. Because the wound is smaller and requires far fewer sutures, there is very little postoperative astigmatism which can delay the visual recovery. The maximum return in vision takes only about 3 to 4 months following DSAEK. Since only the thin inner layer of the cornea is replaced, over 90% of the patient’s own cornea remains behind contributing to greater structural integrity and may reduce the incidence of rejection.

Only patients with endothelial cell problems are candidates for DSAEK. Patients with corneal scarring or other conditions will still require the full-thickness procedure. Since corneal specialists have only been performing DSAEK for a few years, there are no long-term follow-up studies. There is a risk of the thin button of endothelium becoming displaced within the first few days or weeks after surgery and requiring a return trip to the operating room to reposition it. If the DSAEK operation fails, the operation can be repeated with another button of donor endothelium. If the DSAEK fails, either after one or multiple attempts, a traditional corneal transplant operation can be performed.