DSEK (Descemet’s Stripping Endothelial Keratoplasty) is a breakthrough treatment for Fuchs’ Dystrophy, offering a minimally invasive solution to restore vision by replacing the damaged corneal endothelium with healthy donor tissue. This modern procedure can significantly improve visual clarity and reduce discomfort for patients suffering from this progressive eye condition. At our Las Vegas office, our expert cornea specialists provide personalized care using the latest advancements in corneal surgery, helping patients regain their quality of life.
Understanding the nature of Fuchs’ Corneal Dystrophy is crucial in deciding the best treatment path.
Understanding Fuchs’ Corneal Dystrophy
What is Fuchs’ Dystrophy?
- Fuchs’ corneal dystrophy is an inherited eye condition affecting the cornea’s innermost layer, the endothelium.
- The endothelium plays a critical role in regulating corneal hydration by controlling the fluid content within the cornea.
Progression of the Disease:
- The disease causes small bumps called guttae to form on the Descemet membrane, replacing healthy endothelial cells.
- As Fuchs’ dystrophy progresses, the cornea becomes increasingly swollen, leading to blurred vision. By middle age, many patients experience significant vision loss due to the inability of the cornea to stay dry enough for clear vision.
Treatment Options for Fuchs’ Dystrophy
Traditional Treatment:
- Historically, patients with Fuchs’ dystrophy were limited to a full-thickness corneal transplant. However, this approach was less than ideal since only the endothelial layer was damaged, while the other layers of the cornea remained healthy.
Modern Approaches:
- DSEK (Descemet’s Stripping Endothelial Keratoplasty):
- Procedure Overview:
- DSEK is a minimally invasive procedure performed in an outpatient setting at our Las Vegas office.
- The ophthalmologist makes a small incision to remove the diseased Descemet membrane and endothelium.
- A thin graft containing healthy donor endothelial cells is inserted and held in place with an air bubble.
- The incision is tiny and typically self-healing, with patients advised to lie flat post-procedure to facilitate healing.
- Recovery:
- Vision may be blurry immediately after the procedure, but most patients return to work within a week.
- Complete recovery is usually achieved within three months.
- Procedure Overview:
2. Combination with Cataract Surgery:
- For patients who also have cataracts, DSEK can be combined with cataract surgery and intraocular lens implantation.
- This approach not only addresses cataracts but also prevents potential complications like pseudophakic corneal edema.
3. DMEK (Descemet Membrane Endothelial Keratoplasty):
- Procedure Overview:
- DMEK is similar to DSEK but involves transplanting an even thinner layer of donor tissue.
- Benefits and Risks:
- DMEK may offer faster visual recovery and better final visual acuity compared to DSEK.
- However, it is more technically challenging and carries a higher risk of donor tissue detachment after surgery.
Postoperative Care and Long-Term Outlook
Medications:
- After DSEK or DMEK surgery, patients must use medicated eye drops, including antibiotics and topical steroids, to control inflammation and prevent infection.
Patient Compliance:
- Adherence to postoperative positioning and the prescribed eye drops is crucial for achieving the best visual outcomes.
- Despite some endothelial cell loss, with proper care, the transplanted endothelium can remain healthy and functional for many years.
Quality of Life Improvements:
- DSEK and DMEK offer significant improvements in vision, allowing patients to regain independence and enjoy a better quality of life.