CORNEA 32 EWAP JUNE 2023 by Liz Hillman EyeWorld (US) Editorial Co-Director The status of DSAEK and DMEK Contact information Chamberlain: chamberw@ohsu.edu Chan: clarachanmd@gmail.com Venkateswaran: nandini.venkat89@gmail.com Last year, an EyeWorld article took a look at the status of trabeculectomy in glaucoma practice; while it still has a place in the glaucoma treatment paradigm, according to some, it is being taught less and less in training programs in favor of newer therapies. Is the same occurring with DSAEK? Nandini Venkateswaran, MD, and Winston Chamberlain, MD, PhD, both said they had DSAEK training (DMEK wasn’t even a thing when Dr. Chamberlain was in residency or fellowship, he said) and think there continues to be a place for it, even while DMEK has gained increasing popularity. Dr. Chamberlain thinks surgeons in training are likely still getting enough DSAEK exposure. “Most surgeons who perform endothelial keratoplasty are still doing both surgeries, and training centers are teaching these skills to residents and fellows,” he said. “Many residencies, including ours at the Casey Eye Institute, now expose residents to DMEK and DSAEK. Our second year residents assist in both types of procedures and perform a small number during their senior year. Still, a majority of this surgical training takes place during a cornea fellowship. “Both surgeries are taught thoroughly with a variation of techniques to our fellows, but DSAEKs still tend to be skewed toward the more complicated eyes that have had prior vitrectomies, glaucoma surgeries, anterior chamber IOLs, or have abnormal iris anatomy,” Dr. Chamberlain continued. “The 2021 Eye Bank Association of America (EBAA) Statistical Report reflects that DMEK is rising and likely soon, within the next year or two, will equal the number of DSAEKs and PKPs done in the U.S. So, the three types of surgery will almost be even in distribution. Currently, DMEK is the main This article originally appeared in the April 2023 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. DSAEK clear cornea. Anterior segment OCT of DSAEK. Source (all): Clara Chan, MD A 50% bubble on postop day 1 of a DSAEK case. Source: Clara Chan, MD
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