Descemet Stripping Endothelial Keratoplasty (DSEK) is generally performed by most surgeons using a device called microkeratome to "shave" the top layer of the cornea off.  Although this can also be done via surgeon's skills, the smoothness is much finer using the microkeratome.  As a result, the procedure has the automated microkeratome used and therefore the procedure is then referred to by many as the Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) to be technically more specific.

DSEK is a great procedure and has wonderful results as compared with the traditional full penetrating corneal transplant surgery.  Most commonly the greatest "headaches" that arise from DSEK come in the early hours/days of the surgery.  The Detachment of the corneal transplant button from the patient's native cornea ranks by far the highest.  The incidence in the literature is noted anywhere from 4% to 37%.  A reasonable expectation for most should be about 1 in 5 patients may need the button reattached.

I will be presenting some complication cases of the DSEK.  I have found Visante to be absolutely one of greatest tools.  Most often is the button is detached, the cornea becomes very edematous and cloudy and obscures details.  As such the limited visibility through the swollen cornea, air bubble in the anterior chamber and others, can easily be overcome by using the Visante Anterior Segment OCT.

Case of a Stromal Tag