DSAEK, "Descemet Stripping Automated Endothelial Keratoplasty", is the treatment of choice for diseases of the most inner corneal layer, such as Fuchs Endothelial Dystrophy, Cornea Guttata and Bullous Keratopathy.
This type of surgery is ususally performed under local anesthesia, but may also be performed under general anesthesia should the patient desire. If the crystalline lens is still in place, DSAEK is performed in combination with cataract surgery. Starting with a small incision of about 4mm width, the most inner, deseased layer of the cornea is removed with a special hook and spatula. Thereafter, the pre-cut donor-transplant is punched out in the proper size, rolled up and injected into the eye with a special injector system. An air bubble is the injected into the eye that presses the transplant onto the inner surface of the cornea.
In order to check the optimal fit of the transplant, Prof. Findl uses a high-precision OCT scan which is integrated into the surgical microscope. Prof. Findl was the first surgeon worldwide to use the prototype of this special microscope. Using this special equipment helps to make sure that there is no fluid between the transplant and the cornea. This helps to reduce the risk of early detachment of the transplant. The air bubble dissolves within 1 to 2 days. The patient is requested to lie on his back on the first day after surgery. Therefore, patients are typically requested to stay overnight for 1 to 2 nights after surgery.
Using very thin transplants with a thicknes of less than 0.1mm (100 micrometres), visual funciton increases quickly in most patients over 1-2 weeks. This method is called "Ultra-Thin-DSAEK. At Hanusch hospital, this type of surgery is performed routinely by Prof. Findl.