Corneal Surgery (DSEK)

Descemet’s Stripping with Endothelial Keratoplasty (DSEK) is a relatively new corneal transplant procedure that replaces only the inner layers of the cornea as opposed to a traditional corneal transplant where replacement of the full thickness of the central cornea with the full thickness of a donor cornea is performed.

While DSEK is a relatively new procedure, the surgeons at Woolfson Eye Institute (WEI) have helped pioneer it, already performing numerous surgeries with excellent results. The basic DSEK technique removes only the diseased endothelial cell layer from your cornea. A thin slice from the inner portion of the donor cornea is then folded and inserted through a small incision. Your surgeon then injects an air bubble into the eye to unfold the donor tissue and press it into place.

The cornea is composed of five layers, and to see well, all layers must be free of any cloudy or opaque areas. By remaining transparent, the cornea retains its ability to refract light properly.

The endothelium is the extremely thin, innermost layer of the cornea, and healthy endothelial cells are required to keep the cornea clear. Fluid naturally seeps from the inside of the eye into the middle corneal layer (stroma), and the endothelium’s primary task is to pump excess fluid back out. Without this pumping action, the stroma would swell with water, become initially hazy and then ultimately opaque. In a healthy eye, a perfect balance is maintained between the fluid moving into the cornea and fluid being pumped out of the cornea.

Once endothelial cells are destroyed by disease or trauma, they are lost forever. If too many endothelial cells are destroyed, corneal edema occurs, which in turn causes a decrease in vision.

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