Descemet Stripping Automated Endothelial Keratoplasty

Abstract

The standard surgical treatment of corneal endothelial failure used to be a full thickness replacement of the destroyed endothelium by a penetrating Keratoplasty(PKP). PKP elicits a clear cornea. But it entails two major drawbacks, being a full thickness vertical corneal section which results in a tectonically unstable graft. In addition, the graft is fixed in place with sutures which results in astigmatism, slow visual rehabilitation, in addition to other complications as infection, vascularization and persistent epithelial defects. Deep Lamellar Endothelial Keratoplasty (DLEK) helps to achieve a clear cornea, significantly less postoperative astigmatism, faster visual rehabilitation and a very good solution specially for patients having healthy stroma. There are further modifications on the technique that magnify the outcome as Descemet Stripping Endothelial Keratoplasty (DSEK), Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) and Femtosecond laser assisted technique. The aim of this work is to emphasis on Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) as a novel technique of endothelial keratoplasty regarding its indications, the advantages, the disadvantages and complications.