Cornea Transplant

Partial-Thickness Cornea Transplant (DSAEK)

Mayo Clinic ophthalmologists are experienced in the partial-thickness corneal transplant procedure called Descemet-stripping with automated endothelial keratoplasty (DSAEK). It removes only the damaged or diseased inner tissue layers (Descemet's membrane and endothelium) of the cornea, replacing them with healthy tissue from a donor cornea.

Candidates

DSAEK can improve and restore good vision for patients with cloudy or swollen corneas due to corneal endothelial disease. A partial-thickness cornea transplant is recommended when a loss or dysfunction of the inner layer (endothelium) of cornea cells occurs. The surgery is commonly performed to treat Fuchs' endothelial dystrophy.

Procedure

During surgery, a section of the cornea is removed and replaced with a similar section from the donor cornea. Donor cornea tissue is prepared with a special instrument (semiautomated microkeratome) rather than manually. The donor tissue is inserted into the eye through a small incision and secured to the cornea using an air bubble. Stitches are not needed to hold the donor cornea in place.

The surgery usually lasts 60 to 90 minutes. Patients might experience eye irritation, tearing and discomfort for a few days up to two weeks after surgery. Patients should expect improved vision in one to three months. Vision continually improves as the cornea repairs itself over a period of six to 24 months. Patients may still require glasses after surgery to achieve best vision.

Advantages

DSAEK surgery provides a more predictable visual outcome compared to the traditional penetrating keratoplasty cornea transplant procedure, which replaces the entire cornea. Unlike penetrating keratoplasty, stitches do not need to be removed after surgery. The technique results in a smaller incision than a full-thickness cornea transplant, leaving the eye structurally stronger after surgery. Patients experience a minimal change to their existing nearsightedness, farsightedness and astigmatism levels. So, there is no need to wear glasses or contact lenses with a different, stronger prescription to achieve good vision afterward as with full-thickness transplants.