Descemet stripping endothelial keratoplasty (DSEK), available in Indianapolis at Price Vision Group, is a thicker posterior corneal transplant than DMEK. The advantage of the thicker graft is that it is easier for the surgeon to position the tissue behind the patient’s cornea and it adheres easier. There is less likelihood of the patient needing additional air injections to get the tissue to adhere, so there may be fewer post-operative visits for the patient.
The disadvantage of DSEK compared to DMEK is that fewer patients achieve 20/20 vision; the average vision is 20/30 after DSEK. The risk of experiencing a graft rejection episode is lower with DSEK than it is with a full thickness graft, but higher than with DMEK. We have found that about 1 in 10 DSEK patients experience a graft rejection episode within 2 years, whereas the rate is about 1 in 5 patients with a full thickness graft. DMEK provides the lowest risk of graft rejection; fewer than 1 in 100 of our DMEK patients have experienced a graft rejection episode. The rejection rate for DSEK is about 15% compared to less than 1% for DMEK. A full thickness graft has about a 22% rate of rejection.
Whenever possible we recommend the DMEK procedure for diseases confined to the posterior cornea. In eyes with other problems the DSEK surgery may be a better option; only your surgeon can tell you which surgery is right for you. Full thickness corneal transplants are rarely indicated unless all layers of the cornea are diseased.