Your procedure will be performed at Rocky Mountain Surgery Centre, Dr. Demong’s private ambulatory surgical facility adjacent to his Calgary office. Although you will be awake during your procedure, local anesthetic (freezing) causes inability to move the eye and loss of sensation so there is no discomfort at the time of treatment. Our nursing staff will describe the anticipated process and answer your questions as they prepare you and make sure you are positioned comfortably. It is important for you to remain still throughout the procedure that will last 45 to 60 minutes.

 

You will be covered with sterile drapes that are tented so you can breathe comfortably throughout the procedure. Dr. Demong uses a microscope to perform the surgery so you'll notice a very bright light but all movements will appear blurry.

 

Dr. Demong creates a small opening (incision) at the side of the cornea, and, using a specialized instrument, separates and eases the lining and attached membrane away from the upper layers. Then, he takes the prepared donor tissue and inserts it through the small opening in the cornea, carefully positioning it. He’ll insert an air bubble to elevate the donor tissue against the upper layers of the cornea and hold it in place until it is secure, usually within the first 24 hours.   Then he closes the incision with a few fine sutures.

 

Now, we invite you to view an animation of the procedure:

 

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If you require cataract surgery or lens replacement surgery at the time of your DSAEK procedure, it is possible for Dr. Demong to combine both surgeries, saving you the discomfort and time of two separate procedures while optimizing functional vision. 

 

Following surgery, Dr. Demong places a pad over the operative eye. You'll be instructed when to remove it later in the evening. You will not be able to drive after the surgery, nor the day immediately following surgery.

 

When the freezing wears off, you may experience mild discomfort best controlled with the analgesic Dr. Demong recommends. The incision line may feel as if you have a fine hair on the surface of the eye. You can minimize the sensation by using artificial tears following your medicated drops. You will be asked to use a series of medicated drops including an antibiotic and two different types of anti-inflammatory drops as well as a drop to control eye pressure.

 

You'll remain at the Surgery Centre for at least two hours after surgery reclining flat on your back to ensure the air bubble supports the graft securely in place. Dr. Demong examines you before you leave the Centre as well. You may sit briefly during the drive home but we caution you to remain flat on your back throughout the first evening and night upon arrival at home. If you are from outside Calgary, you will need to stay in the city for the first evening.  

 

Substantial vision improvement is usually attained within weeks of surgery, depending upon the condition of your eye and your individual recovery but best vision may take several months. Fluctuations in vision are normal throughout your recovery.

 

Right after DSAEK surgery, Dr. Demong’s greatest concern involves healing of the graft securely in its proper position. It may be necessary to inject another air bubble the day after surgery to support the graft. As well, Dr. Demong will monitor you for signs of graft rejection and other problems such as infection, bleeding, and increased eye pressure. Because medications minimize the risk of most of these adverse reactions, it is essential to follow all instructions precisely.

 

Visual rehabilitation is faster than conventional transplant surgery, recovery is more comfortable and it results in a stronger cornea after recovery.