Austin TX Corneal Transplant Surgery

Descemet’s stripping endothelial keratoplasty was the preferred treatment for corneal endothelial dysfunction from 2008-2013. Descemet’s Stripping Endothelial Keratoplasty (DSEK) is a posterior corneal transplantation technique that replaces dysfunctional recipient endothelium with healthy donor tissue while sparing the entire recipient stroma. DSEK is currently recognized as the “state-of-the-art” in the endothelial keratoplasty field. DSEK produces excellent visual outcomes with minimal change in corneal surface topography or refraction. It can successfully treat corneal dysfunction associated with Fuchs’ endothelial dystrophy, bullous keratopathy, iridocorneal endothelial syndrome or a failed cornea transplant. Donor dissection has become automated, and new techniques have been devised to facilitate graft insertion and unfolding. We now routinely perform DSEK with topical anesthesia. Graft detachment is the most frequent early postoperative complication, but new methods can help promote donor adherence. The incidence of graft-rejection episodes is lower after DSEK compared with standard penetrating keratoplasty, possibly because wound healing is a lesser concern.