Frequently Asked Questions about DSAEK

Where is the procedure performed?

DSAEK is performed in an outpatient surgicenter. No hospitalization is required.

How long does the procedure last?

The total time the patient will be in the surgicenter is approximately 2 to 2.5 hours. Once the patient is taken to the operating room the procedure is completed in 20 to 30 minutes. Additional time may be necessary if other procedures are also planned ie cataract surgery or intraocular lens replacement. After the procedure is completed the patient is taken to the recovery room where they must lie on their back for 45 to 60 minutes. This allows the air that has been placed in the anterior chamber of their eye to fix the transplant into position.

When will I need to return for a followup office visit?

The first office visit is scheduled about 1.5 to 2 hours after the DSAEK procedure has been completed. After leaving the surgicenter you will be taken to my office. The visit is necessary so that I can remove the air that was placed in your eye. Since your eye is still totally numb you will not experience any pain while I remove the air. Removal of the air only takes a few seconds and is necessary so that you do not experience an intraocular pressure spike during your first post op evening. Removal of all the air is not required and some air usually remains in the eye to help maintain the transplant in proper position. You will also return for a follow up visit the next day after surgery. During this visit the health and position of the new transplant will be checked. If everything is in proper order you will start your post op eye drops as directed and return for a follow up visit in 1-2 weeks.

What type of eye drops will I need after surgery?

You will continue using antibiotic eye drops (Vigamox) that you started three days prior to surgery. Use the Vigamox 4x per day for one week after surgery unless otherwise instructed. You will also use a steroid eye drop (Econopred 1% or Pred Forte) 4x per day until otherwise instructed. The steroid drops are required to prevent rejection of your new transplant. If you are also using glaucoma eye drops continue to use them after surgery unless otherwise instructed.

When will I see an improvement in my vision?

Visual recovery varies depending on the severity of your corneal cloudiness prior to surgery. Most patients notice improvement in their vision during the first two weeks after surgery with continued improvement during the next four to six weeks. This recovery represents a dramatic improvement over the time required following conventional corneal transplant surgery (PKP), which usually takes six to twelve months. Some DSAEK patients may not notice visual improvement as quickly as they would like, because they have other ocular conditions such as cataract or retinal problems that must be addressed.

Can my DSAEK transplant undergo rejection?

Although the rate of rejection with DSAEK does not appear to be any higher than rejection rates with PKP, endothelial rejection can occur following DSAEK. The signs and symptoms of such rejection episodes are the same as they are for PKP patients. Briefly, if you experience redness, photophobia (light sensitivity) and blurred vision assume that you are having a rejection episode and call my office so that you can be evaluated immediately. Most rejection episodes are successfully terminated by using steroid eye drops. The sooner a rejection is treated the better chance for transplant survival.