Sutureless Corneal Transplantation

What is DSEK?

DSEK( Descemets Stripping Endothelial Keratoplasty)refers to a new method of advanced corneal surgery, wherein the dysfunctional endothelial layer of the cornea is selectively replaced with healthy donor tissue, without the need for surface incisions or sutures. Tectonically the cornea is much stronger following DSEK as compared to conventional full thickness corneal transplant

Before DSEK came in to practice, conventional corneal transplantation was the only solution for those ailing with corneal diseases.

What is conventional corneal transplantation?

Conventional corneal grafting procedure requires full thickness excision of the host cornea, followed by replacement of corneal tissue from donor cornea. This corneal tissue needs to be secured in position with multiple sutures.

How is DSEK better than conventional corneal transplant?

• Advantages of endothelial keratoplasty over traditional penetrating keratoplasty (PK) include rapid recovery times, decreased postoperative astigmatism, decreased risk of suture related complications. Tectonically the cornea is much stronger following DSEK as compared to conventional full thickness corneal transplant.
• Advantages of endothelial keratoplasty over traditional penetrating keratoplasty (PK) include rapid recovery times, decreased postoperative astigmatism, decreased risk of suture related complications. Tectonically the cornea is much stronger following DSEK as compared to conventional full thickness corneal transplant.
• Descemet’s Stripping Endothelial Keratoplasty (DSEK) include rapid recovery times, decreased postoperative astigmatism, decreased risk of suture related complications. Tectonically the cornea is much stronger following DSEK as compared to conventional full thickness corneal transplant.

Corneal Dystrophies

Corneal dystrophy is a condition in which one or more parts of the cornea lose their normal clarity. There are over 20 corneal dystrophies that affect all parts of the cornea. Some cause severe visual impairment while a few cause no vision problem and are discovered during a routine eye examination. Other dystrophies may cause repeated episodes of pain without leading to permanent loss of vision.

Some of the most common corneal dystrophies include:

• Fuchs' dystrophy
• Lattice dystrophy
• Map-dot-fingerprint dystrophy

Corneal Ectatic Disorders

These disorders are characterized by a progressive change in the shape of the cornea that results in a decrease in vision. Contact lenses are of benefit and obviate the need for surgery in most cases. However, a small portion of patients reach the point where they need a cornea transplant.

Some of the common diseases include:

• Keratoconus
• Pellucid marginal degeneration
• Terriens marginal degeneration

Corneal Injury

injuries may result from severe blunt trauma or any kind of penetrating injury. The aim is to restore and maintain the integrity of the globe, avoid further intraocular damage and prevent permanent corneal scarring and astigmatism.

Surgical facilities offered by the cornea service:

transplantation which involves replacing a diseased or scarred cornea with a new one. In corneal transplant surgery the surgeon removes the central portion of the cloudy cornea and replaces it with a clear cornea. The chances of success of this operation have risen dramatically because of technological advances. Corneal transplantation has restored sight to many, who a generation ago would have been blinded permanently by corneal injury, infection, or inherited corneal diseases or degeneration. Recent modified forms of corneal transplant called Lamellar Keratoplasty are also performed. This involves removing only the partial thickness of the cornea that is diseased leaving the rest of the healthy cornea undisturbed. Lamellar Keratoplasty is of two types: Deep anterior lamellar Keratoplasty (DALK) and Deep lamellar endothelial keratoplasty (DLEK)

Refractive and Other Laser Procedures

Corneal injuries may result from severe blunt trauma or any kind of penetrating injury. The aim is to restore and maintain the integrity of the globe, avoid further intraocular damage and prevent permanent corneal scarring and astigmatism.

• LASIK: An acronym for Laser-assisted In Situ Keratomileusis, is a form of refractive laser eye surgery procedure performed by cornea specialists as an alternative for people wearing glasses and contact lenses.
• PRK: Photo Refractive Keratectomy is an excellent alternative to LASIK in selective cases where LASIK cannot be performed due to safety considerations as corneal thickness may be inadequate.
• PTK: Photo therapeutic Keratectomy is an excimer laser based therapeutic surgery done for numerous conditions ranging from corneal dystrophies to recurrent corneal erosions. It not only improves vision but also brings relief from recurrent episodes of painful red eye and also helps to delay the need for cornea transplantation.

Other Corneal surgical procedures: