Endothelial Keratoplasty:

In conventional corneal transplant surgery (Penetrating Keratoplasty), the surgeon removes the window of cloudy tissue from patient’s cornea and replaces it with a clear corneal tissue. This transplanted cornea is held in its place with multiple tiny stitches. To allow healing, these stitches must remain in their place for at least 6 months. These stitches induce an irregular spectacle number (irregular astigmatism) in the eye and it takes long to get a clear vision.

DSEK and DSAEK is a selective keratoplasty in which only the diseased endothelial layer of cornea is replaced by a healthy donor tissue. The procedure requires precision guided dissection of donor tissue to retrieve only the innermost layers of cornea. This can be accomplished with an automated micro-keratome or by Femtosecond Laser (IntraLaseTM). As less tissue is transplanted, lower rejection rates may be expected, esp. epithelial and stromal rejection. DSEK/DSAEK procedure requires less number of sutures, it is safer and visual recovery is faster compared to conventional penetrating corneal transplant.

What happens if the graft fails?

Graft failure can occur due to infection, rejection or glaucoma. Should the graft fail, it can be replaced by a repeat corneal transplantation.