LaserVision

Treatment at a glance

30 minutes

Local anaesthetic

7 - 14 days

Permanent

Improve vision

The endothelial cell layer is a very delicate single layer of cells that maintains the clarity of the cornea.

If they malfunction or are damaged they can lead to clouding of the cornea. Unfortunately this layer of cells does not regenerate. So if they are no longer functioning, then the treatment is to replace this layer with a donor layer.

The faulty inner layer of corneal cells is removed and replaced with the layer of cells taken from a donated human cornea. In a DSAEK procedure the implanted donor material consists of a thin layer of stroma carrying the endothelial cell layer, and is 60-120 microns thick.

The stromal layer carrying the endothelial cells facilitates the transfer and positioning of the endothelium.

 

The endothelial cell layer is a very delicate single layer of cells that maintains the clarity of the cornea.

If they malfunction or are damaged they can lead to clouding of the cornea. Unfortunately this layer of cells does not regenerate. So if they are no longer functioning, then the treatment is to replace this layer with a donor layer.

The faulty inner layer of corneal cells is removed and replaced with the layer of cells taken from a donated human cornea. In a DSAEK procedure the implanted donor material consists of a thin layer of stroma carrying the endothelial cell layer, and is 60-120 microns thick.

The stromal layer carrying the endothelial cells facilitates the transfer and positioning of the endothelium.

 

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Treatment Benefits Benefits

What are the benefits of DSAEK (Corneal Endothelial Transplant)?

  • Improve vision
  • Treat corneal failure / decompensation

How is it performed?

  • 1.Performed under local or general anaesthetic in sterile operating theatre.
  • 2.Patient is laid flat on the treatment bed.
  • 3.Povidone iodine clean, sterile drape applied, and eyelid support inserted.
  • 4.Faulty / failing corneal endothelium is removed and the donor cornea endothelial transplant inserted.
  • 5.Graft is secured in place with air or an SF6 bubble which tamponades the graft against the inside of the cornea.
  • 6.Topical anti-inflammatory and antibiotic drops are applied, and the patient is advised to lie flat on back as much as possible (45 minutes in every hour) for the first 2-3 days post-surgery.
LaserVision-Treatments-DSAEK-How
LaserVision-FAQ-Main

A Descemet’s membrane endothelial keratoplasty (DMEK) is very similar to DSAEK, except that the implanted donor tissue does not include any stromal tissue. DMEK surgery is a replacement of solely endothelium and is thus a more anatomically like-for-like repair.

Visual recovery after DMEK / DSAEK takes 1-4 weeks. Typically vision is poor in the first few days due to the air bubble. Vision begins to improve once the bubble is above the level of the pupil. Good vision can be expected a month after surgery. New glasses can typically be measured 6 weeks after surgery.

The front chamber of the eye will be filled with gas / air which causes a temporary reduction in vision as it’s not possible to see through an air bubble in the eye. Vision will typically be worse than before the surgery until the gas bubble is reabsorbed. You will be able to see light and blurred shapes. You will not be able to read with the operated eye. As the air bubble absorbs and disappears, it will move upwards (air floats on water), and one may be able to see the meniscus of the bubble as a dark curved line in your vision. The bubble can be seen externally if you look at the eye in the mirror. Once the air is above the level of the pupil, vision will begin to return. The air bubble will typically disappear completely 5-7 days after surgery. If you have had a vitrectomy in the past there can also be air that travels to the back of the eye and you may then see two bubbles. This will also disappear. Some irritation, grittiness or aching of the eye is normal after DMEK/DSAEK. Severe pain is unusual. The eye can also feel itchy. It is important not to rub or touch the eye. Follow the instruction you were given regarding medication.

Although Laser Vision takes great care of their patients and complications are uncommon, the following conditions may occur after surgery: elevated intraocular pressure, graft dehiscence or dislocation, infection and allergies.

Surgery takes around 30 minutes and is usually performed under local anaesthetic. It can be combined with cataract surgery if required.

Choosing the right vision correction clinic for your surgery is paramount. This is a life changing procedure after all, and you need to have complete trust in your surgeon and care team of professionals.

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Choosing the right vision correction clinic for your surgery is paramount. This is a life changing procedure after all, and you need to have complete trust in your surgeon and care team of professionals.

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