| Typically, these conditions arise in older patients who may also have cataracts, and the practice has been to treat the corneal disease and the cataract removal as separate procedures. The 2 surgeries are often performed weeks or months apart, with or without the implantation of an intra-ocular lens (IOL). Farrah Newman MD, University of Mississippi Medical Center, Jackson, Mississippi, and colleagues performed all 3 procedures -- DSEK, phacoemulsification, and IOL implant -- simultaneously, with positive short-term refractive outcomes. Until quite recently, patients with Fuch's syndrome and other diseases of the corneal endothelium have had few treatment options. Cornea transplant, if available, was usually their only hope. The DSEK procedure entails opening the edge of the cornea with a small slit, similar to what the ocular surgeon would do when removing a cataract. The inner layer of the cornea is then "scraped" to remove the diseased tissue. The endothelium is replaced with a new layer, consisting of a cadaver cornea. This section of cornea is folded into the shape of a taco and inserted inside the patient's open anterior chamber. It is held in place against the diseased cornea with compressed air. Among the benefits of DSEK is that the patient spends less time waiting for a corneal transplant, and there is less risk of complication once the transplant material becomes available. In the study, 8 eyes had the DSEK-phacoemulsification-IOL implant done at the same time. These patients had a mean postoperative best corrected visual acuity (BCVA) of 20/50 at 1 month, 20/40 at 2 months, and 20/30 at 4 mont | 
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