Endothelial Keratoplasty Has Been Adopted Worldwide As An Alternative To Penetrating Keratoplasty In The Treatment Of Corneal Endothelial Disorders. Descemet Stripping (Automated) Endothelial Keratoplasty (DSEK/DSAEK) May Be The Current Standard, Whereas Descemet Membrane Endothelial Keratoplasty (DMEK),
The Procedure Involves Peeling Off The Inner Two Layers Of The Diseased Cornea. A Donor Cornea Is Then Split Or Dissected To Create A Flap Of The Inner Two Layers And A Small Portion Of Stroma (To Provide Substance For Manipulation). This 3 Layer Donor Is Then Folded And Inserted Into The Eye And Floated Up To Stick Onto The Inside Of The Cornea Replacing The Layers Removed Earlier.
The Procedure Is Technically Challenging, However Can Be Accomplished Very Quickly Often With No Stitches At All! The Procedure Is Becoming More And More Popular And Will In Time Become The Gold Standard. We At Centre For Sight And The Corneoplastic Unit Perform This Procedure Regularly And Have Developed Instrumentation To Make The Process Easier.
- Closed Eye Surgery
- Rapid Surgery
- Rapid Visual Recovery
- Easily Replaceable
- Technically Challenging
- Grafts Can Dislocate Early Requiring Further Minor Intervention
- Interface Haze Can Compromise Visual Clarity
DSEK - 3 Months Following Surgery
FutureOne Of The Most Challenging Aspects Of DSEK Surgery Is Creating A Reproducible Donor Layer. This Can Vary Considerably And Its Irregularity Could Theoretically Affect Visual Outcomes. The Intralase Femtosecond Laser Is Able To Separate The Cornea Precisely And Its Use In Fashioning Precise Donor Lenticules Is Currently Being Investigated. If Found To Be Safe, DSEK And Posterior Lamellar Keratoplasty Will Become More Reproducible Which Resulting In Consistently Better Outcomes.
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