Descemet-stripping Automated Endothelial Keratoplasty—A Review

Abstract

Descemet-stripping automated endothelial keratoplasty (DSAEK) has become the procedure of choice to treat corneal endothelial dysfunction. The technique involves replacing the diseased host endothelium with a graft consisting of a thin layer of posterior stroma, Descemet membrane, and endothelium. In comparison to penetrating keratoplasty (PK), DSAEK confers quicker visual and structural recovery with absence of corneal surface incisions or sutures, and limits astigmatism. DSAEK has been proved to successfully achieve favorable visual acuity and graft clarity in bullous keratopathy, posterior polymorphous dystrophy, and failed PK grafts. This article discusses various DSAEK surgical techniques, short- and longterm post-surgical results, complications, and comparisons with other types of keratoplasty. With the advent of Descemet membrane endothelial keratoplasty (DMEK), in which only Descemet membrane is transplanted, visual rehabilitation may be attained sooner.