Corneal transplantation, which is also referred to as corneal grafting, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue.
Corneal Surgery is referred to as Keratoplasty.
When the entire cornea is replaced it is known as “Penetrating Keratoplasty” and when only part of the cornea is replaced it is known as “Lamellar Keratoplasty”. There is also “Endothelial Keratoplasty” which replaces the patient’s endothelium with a transplanted disc of posterior stroma/Descemet’s/endothelium (DSEK) or Descemet’s/endothelium (DMEK).
This relatively new procedure has revolutionized the treatment of disorders of the innermost layer of the cornea (endothelium).
Unlike the full-thickness transplant of the cornea, the (DSAEK/DMEK) surgery can be performed with one or no sutures. Patients may recover functional vision in days to weeks, as opposed to up to a year with full-thickness transplants.
During surgery, the patient’s corneal endothelium is removed and replaced with donor tissue. Both procedures are outlined further below.
DSAEK stands for Descemet’s Stripping Automated Endothelial Keratoplasty, which is a partial-thickness corneal transplant that replaces only the innermost layer of the cornea. DSAEK is a surgical technique that affords significant improvements over traditional corneal transplants for certain indications. DSAEK is the most common type of Endothelial keratoplasty procedure and the surgeon implants the back 20-30% of a donor cornea into the patient’s eye.
DMEK stands for Descemet’s Membrane Endothelial Keratoplasty, which is also a partial-thickness corneal transplant procedure that involves selective removal of the patient’s Descemet membrane and endothelium, followed by transplantation of donor corneal endothelium and Descemet membrane without additional stromal tissue from the donor. The graft tissue is usually only 10-15 microns thick.