if by any means, the front part of the eye [cornea] is damaged or scarred, then that eye will not be able to see properly. In such cases, the diseased whitish cornea is replaced by healthy cornea of donor [from eye donation], so that the patient will be able to see again. There are many types of keratoplasty [cornea transplant] – penetrating and lamellar. Penetrating is usually done when the whole cornea is involoved in the disease process. In lamellar – anterior is DALK –deep anterior lamellar keratoplasty and posterior – DSEK-descemet’s stripping endothelial keratoplasty.
DALK is done mainly for anterior corneal pathologies like scar, dystrophy, degeneration, keratoconus, etc. DSEK is done mainly for corneal endothelial dysfunction [corneal edema post cataract surgery, fuch’s corneal dystrophy, etc]. For purpose – optical keratoplasty to regain vision and therapeutic keratoplasty to save the eye in case of severe infection of cornea.
DSEK [Descemet’s Stripping Endothelial Keratoplasty] means that only the posterior part or the endothelium of the patient’s eye is changed. When the cornea becomes hazy due to the dysfunction of its porterior layer [endothelium] as in psedophakic bullous keratopathy [corneal blindness post cataract surgery] or in fuch’s endothelial dystrophy, then the patient is not able to see. In such cases, replacing the posterior part – endothelium gives the patient an almost perfect vision. The advantages of DSEK over traditional keratoplasty are that it is sutureless, so chances of astigmatism and rejection are much lower, and the unaided vision of the patient is near normal!