DSAEK- Postoperative Positioning and Transplant Dislocation

• Graft dislocation measured by slit lamp examination [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  Graft dislocation is checked 2 hours postoperatively, they day after the surgery, 1 week after, 1 month, and then every 3. month for 1 year, and then every 6. months for 5 years.
  
  

• Intraocular pressure (IOP) [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  The intraocular pressure (IOP) is measured at every postoperative control
  
  
• Visual Acuity [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  Visual Acuity is measured at every postoperative control
  
  
• Endothelial cell count of the graft [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  Endothelial cell count of the graft is measured at every postoperative control
  
  

Corneal transplant is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft) in its entirety (penetrating keratoplasty) or in part (lamellar keratoplasty). One type of lamellar keratoplasty is DSAEK (Descemet's Stripping Automated Endothelial Keratoplasty), where only the damaged posterior section of the cornea is replaced.

To get the graft in the right position inside the eyes anterior chamber, the anterior chamber is fully filled with air, and the patient is placed in a supine position looking facing up for different amount of time depending on the surgeon. In this way the air bubble will press the graft in the right position and prevent dislocation. Our experience is that since the anterior chamber of the eye already is fully filled with air, it does not matter how the patient is positioned postoperatively regarding graft dislocation.

Our hypothesis is that the immediate postoperative positioning is insignificant. If this can be significantly proved this may enhance the patients comfort postoperatively.