The cornea is the clear covering of the front of the eye which bends, or refracts, light rays as they enter the eye. For clear vision to occur, the cornea must have the correct shape and clarity to focus incoming light rays precisely on the retina at the back of the eye. When the cornea becomes cloudy or misshapen from injury, infection or disease, transplantation may be recommended to replace it.
There are several different corneal transplant procedures available to help restore vision in patients with corneal problems. The traditional corneal transplant procedure involves replacing the entire damaged cornea with a healthy one from a human donor, which is obtained from an eye bank. However, technological advances have allowed for the development of specialized procedures that replace only the damaged part of the cornea, while leaving the healthy parts intact.
Short for Descemet's stripping and automated endothelial keratoplasty, DSAEK replaces only the innermost layers of cells within the cornea, known as the endothelium. This allows the procedure to be performed through a much smaller incision with shorter recovery times and fewer risks than a traditional corneal transplant.
DSAEK is commonly performed on patients with Fuchs' Dystrophy, an inherited eye disease that causes the cells of the endothelium to deteriorate, resulting in distorted vision and corneal swelling. As this condition progresses, vision will continue to worsen as damaged cells cannot grow back.
During the DSEAK procedure, your surgeon will make an incision in the sclera, the white part of the eye. This incision allows the surgeon to access the cornea and removed the damaged endothelial tissue using a microkeratome blade, the same instrument used during LASIK surgery. The donor tissue is then folded and implanted on the eye and the incision is closed with a single stitch.
After the donor tissue has been placed, it will either unfold on its own or be unfolded by the surgeon. Another stitch will then be used to secure the new cornea in place, while an air bubble is injected to properly position it. This procedure is performed under general anesthesia and takes approximately 45 to 60 minutes.
Recovery from DSAEK
After the DSAEK procedure, patients will be moved to a recovery room, where they will be monitored for about an hour before being able to go home. Once the patient returns home from the surgical center, they will be required to lay flat for 24 hours. Your doctor will prescribe antibiotic and steroid eye drops to be used as the eye heals. You will need to return to your doctor the next day for a follow-up appointment.
Most patients notice improvements to their vision within the first two weeks after surgery, with results continuing to develop in the following months. This is significantly faster than the traditional corneal transplant procedure, which may take six to 12 months before effective results are achieved. Other existing eye conditions may slow or hinder the improvement of vision after the DSAEK procedure.
Risks of DSAEK
While the DSAEK procedure is considered safe for most patients with cornea damage, there are certain risks involved with any type of surgical procedure, including infection, bleeding and more. Although rare, there is a risk of transplant rejection, which may result in redness, sensitivity to light and blurred vision. If you are experiencing these or any other symptoms after DSAEK, you should contact your doctor to prevent any damage from occurring.
To learn more about the DSAEK corneal transplant procedure, and to find out whether or not this procedure is right for you, please call us today to schedule a consultation.
Glaucoma is the leading cause of blindness and visual impairment in the U.S., and can affect patients of all ages, many of who do not experience any symptoms and may not be aware that they have the disease. Glaucoma actually refers to a group of diseases that cause damage to the optic nerve as a result of increased pressure within the eye, but can also be caused by a severe eye infection, injury, blocked blood vessels or inflammatory conditions of the eye.
There are two main types of glaucoma, open-angle and angle-closure. Open-angle glaucoma is the most common type of glaucoma and involves fluid in the eye not draining properly through the trabecular meshwork. Angle-closure glaucoma involves a sudden buildup of pressure in the eye and poor drainage because the angle between the iris and the cornea is too narrow.
While some patients may experience symptoms from glaucoma as the disease progresses, others do not learn they have the condition until they undergo a routine eye exam. Tonometry (checking the eye pressure), fundus exams, and visual field testing are all used to diagnose glaucoma.
Treatment for Glaucoma
Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage from occurring. Most cases of glaucoma can be treated with eye drops, laser or microsurgery. The best treatment for your individual case depends on the type and severity of the disease, and can be discussed with your doctor.
- Eye drops are used to reduce fluid production in the front of the eye or to help drain excess fluid, but can lead to redness, stinging, irritation or blurry vision. Patients should tell their doctor about any allergies they have to minimize the risk of side effects.
- Laser surgery for glaucoma aims to increase the outflow of fluid from the eye or eliminate fluid blockages through laser trabeculoplasty, iridotomy or cyclophotocoagulation.
- Microsurgery involves a surgical procedure called a trabeculectomy, which creates a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma. Surgery is often performed after medication and laser procedures have failed.