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Types of Partial Thickness Transplants in New York City




What Is DSAEK?

In the normal eye, a layer of cells known as the endothelium lines the inner surface of the cornea on a membrane called Descemet’s membrane. These cells act as tiny pumps that precisely regulate the amount of fluid in the cornea to maintain its clarity


Medical conditions such as Fuchs’ corneal dystrophy, cataract surgery and glaucoma can lead to a decreased number of these cells. This may result in swelling and clouding of the cornea, causing decreased vision and sometimes episodes of severe pain. Advances in surgical techniques have allowed us to remove only the diseased layer of the cornea and replace it with a thin layer of donor tissue containing healthy endothelial cells. We inject an air bubble to hold this graft in position for the first few days until the pumping new cells create enough suction to hold the graft in place unassisted. The patient needs to lie flat on his/her back for several days so that the air bubble in the eye pushes the donor corneal tissue against the back layer of the patient’s cornea.

What to Expect from DSAEK?

Like a standard, full-thickness corneal transplant, this procedure is done on an outpatient basis. Visual recovery is more rapid after DSAEK, with stabilization of vision often occurring within three to four months after surgery. After DSAEK, vision remains more stable than it does with full-thickness corneal transplant. There is also a lower lifetime risk of graft rejection than in full-thickness transplantation.
Video: https://www.aao.org/annual-meeting-video/endothelial-disease-dsaek-as-gold-standard
(if can link to just the video)


What is DMEK?

DMEK is a partial-thickness cornea transplant procedure that involves selective removal of the patient’s Descemet membrane and endothelium, followed by transplantation of donor corneal endothelium and Descemet membrane without additional stromal tissue from the donor. The graft tissue is merely 10-15 microns thick. After injecting the tissue into the anterior chamber, Dr. Rapoport orients and unscrolls the graft, and a bubble of 20% sulfur hexafluoride (SF6) is placed in the anterior chamber to support graft adherence.


DMEK offers the most rapid visual rehabilitation of any keratoplasty technique to date. Final visual acuity can be outstanding due to minimal optical interface effects. Because less tissue is transplanted, there is a lower risk of graft rejection and less long-term reliance on topical steroids compared with other types of keratoplasty.

What is the difference between DMEK and DSAEK?

The indications for DMEK are similar to those for DSAEK, including endothelial dystrophies (such as Fuchs corneal dystrophy and posterior polymorphous corneal dystrophy), pseudophakic bullous keratopathy, and other causes of corneal endothelial dysfunction.



DMEK & DSAEK with Dr. Rapoport in NYC

At Manhattan Eye, Dr. Rapoport brings the latest advancements in imaging and surgical techniques to provide the most modern techniques to patients in need of a corneal transplant. She is an expert at DMEK, DWEK, and DSAEK and has published on the post-operative care of these surgeries. She brings her delicate surgical touch and warm bedside manner in guiding you through the corneal transplant process.

Dr. Rapoport helps explain everything you need to know about how long does makeup last and expired makeup...

In the article “What You Need to Know About Dry Eye Syndrome”, Dr. Rapoport provides questions to ask yourself if you’re wondering whether or not you have dry eye syndrome.

Dr. Rapoport is interviewed for Women Crush Wednesday, a celebration of female movers and shakers in medicine.