Descemet-stripping endothelial keratoplasty (DSEK) is a partial-thickness corneal transplant procedure. This procedure removes only the damaged or diseased inner tissue layers (Descemet’s membrane and endothelium) of the cornea, replacing them with healthy tissue from a donor cornea.

DSEK can improve and restore vision for patients with cloudy or swollen corneas due to corneal endothelial disease. A partial-thickness cornea transplant is recommended when a loss or dysfunction of the inner layer (endothelium) of cornea cells occurs. The surgery is commonly performed to treat Fuchs’ endothelial dystrophy and other endothelial disorders.

During surgery, a section of the cornea is removed and replaced with a similar section from the donor cornea. Donor cornea tissue is prepared with a special instrument. The donor tissue is inserted into the eye through a small incision and secured to the cornea using an air bubble. Stitches are not needed to hold the donor cornea in place.

The surgery usually lasts 45-60 minutes. Patients might experience eye irritation, tearing and discomfort for a few days up to two weeks after surgery. Patients should expect improved vision in one to three months. Vision continually improves as the cornea repairs itself over a period of six to 24 months. Patients may still require glasses after surgery to achieve best vision.

DSEK surgery provides a more predictable visual outcome compared to the traditional penetrating keratoplasty or cornea transplant procedure, which replaces the entire cornea. Unlike a penetrating keratoplasty, stitches do not need to be removed after surgery. DSEK results in a smaller incision than a full-thickness cornea transplant, leaving the eye structurally stronger after surgery.