The cornea, the transparent front "window of the eye", is responsible for about
two thirds of the focusing power of the eye. The cornea's refractive power is actually
greater than that of the eye's lens.
The cornea receives its nutrients through the tear film. A normal, healthy cornea
should be transparent, thus devoid of blood vessels and opacities. Corneal tissue
can become damaged through disease or trauma. This damage can cause scar tissue
and opacities in the normally-clear cornea, resulting in a reduction in visual acuity.
If the cornea develops visually significant opacities or irregularities, a corneal
transplant, or DSAEK procedure can be performed.
Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) involves surgically
replacing diseased cornea tissue with donor cornea tissue. Instead of the entire
cornea being removed and replaced, only the damaged layer of tissue is replaced,
making DSAEK a much less invasive option than the traditional method of total corneal
This less invasive procedure leads to rapid recoveries and reduces the risks of
sight threatening complications like hemorrhaging, infection and wound rupture.
Who is a candidate?
DSAEK is a preferred surgical procedure over corneal transplant, but it is not for
everyone. Only those corneas with defects and damage limited to the inner cornea
layer (endothelium) are candidates for DSAEK. Eyes with corneal scars are not good
candidates for DSAEK and will be considered for full corneal transplant surgery.
A common disease that can cause damage to this inner layer of the cornea is Fuchs'
Corneal Dystrophy. This inherited eye disease causes the cornea to swell opacify
and distort vision.
Is ultraviolet light harmful?
Ultraviolet a light used in this procedure is not harmful to the eye in measured
doses. The light emitting diodes used in the C3-R device is of a wavelength that
is not harmful. Furthermore, light emission is carefully measured and calibrated
prior to each treatment.
DSAEK is an outpatient procedure. No hospitalization is required. The entire surgery,
including prepping the eye, usually takes between 45 and 60 minutes.
After the eye is cleaned and prepared with a sterile drape, a small incision is
made at the edge of the cornea. Through this tiny incision, the diseased inner layer
of cornea is peeled away and removed. The donor cornea's inner layer is separated
from the other layers with a precision machine called a microkeratome. This ultra-thin
"button" of cornea is then carefully folded and inserted into the eye through the
incision and attached to the back, inner "dome" of the cornea. The donor tissue
is then held in place with an air bubble until it adheres to its new place in the
patient's eye, usually in about 24 hours.
The small incision is then secured with one small suture.
In most cases, the vision will begin to improve in about one week. Full recovery
is typically 3 months.