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Corneal endothelial dysfunction from disease or trauma is one of the leading indications for corneal transplantation. In the past, the only solution for endothelial replacement was through full thickness corneal transplantation. While the full-thickness corneal transplant, also known as penetrating keratoplasty (PK), has been shown to replace the diseased corneal endothelium with healthy donor tissue, this procedure has been plagued by the inherent problems of unpredictable surface topography, retained surface sutures, and poor wound strength.
In 1998, Dr. Melles from the Netherlands described a new corneal endothelial transplant technique in the first human patients and called it posterior deep lamellar keratoplasty (DLEK). All of this work represents a radical departure from the conventional corneal transplant technique in that the DLEK surgery accomplished the goal of endothelial replacement without ever touching the surface of the recipient cornea. By eliminating surface corneal sutures and incisions, the advantages of normal corneal topography and faster wound healing were obtained, leading to faster visual rehabilitation and a more stable globe for the patient.
In recent years, a modification of the endothelial keratoplasty utilizing the stripping of Descemet’s membrane has been popularized as Descemet's Stripping Endothelial Keratoplasty (DSEK). The DSEK procedure has the advantage of providing a smoother interface on the recipient side for the visual axis. Preparation of the donor tissue in endothelial keratoplasty has also been made easier with the utilization of an automated microkeratome, and the addition of this component to the surgical procedure has been described as Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK).
Currently, we use a Moria microkeratome and artificial chamber system for the preparation of donor material for DSAEK. Dr. Bo Huang, our corneal specialist at UMMC, is the first eye surgeon in Mississippi to offer this procedure to our patients.
For more information, contact Dr. Bo Huang at the UMMC Department Ophthalmology, (601) 815-3248.
2500 North State Street
Jackson, MS 39216