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Refractive
General
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Corneal Transplant & DSAEKThe cornea is the clear front "window" of the eye and provides much of the eye’s optical power (by transmitting light to the interior of the eye allowing us to see clearly). Corneal injury, disease, or hereditary conditions can cause clouding, distortion, and scarring. Like frost on a glass windowpane, this cloudiness blocks the clear passage of light to the back of the eye and reduces sight. As this happens, the only way to restore sight is to replace or transplant the cornea. A corneal transplant is the removal of the diseased central portion of your cornea, and replacement of that tissue with a clear or clouded donor cornea. Corneal transplantation is the most successful of all tissue transplants. 40,000 corneal transplants are done each year in the United States. The success rate depends on the cause of the clouding. For example, corneal transplants for degeneration following cataract surgery and those for keratoconus both have high success rates, while corneal transplants for chemical burns have lower success rates. NEW DSAEK: partial thickness, near-sutureless corneal transplants This is the newest breakthrough in corneal transplant surgery because simply sometimes only a portion of the cornea needs to be replaced. DSAEK (Descemet Stripping Automated Endothelial Keratoplasty) removes the unhealthy, diseased, posterior portion of a patient’s cornea and replaces it with healthy donor tissue. Unlike conventional corneal transplant surgery, the DSAEK procedure utilizes a much smaller surgical incision and requires no corneal sutures. The donor cornea is placed in the eye folded and is then gently unfolded using an air bubble to aid in attaching the donor tissue to the patient's own cornea. This usually results in more rapid recovery of vision for the DSAEK patient and also reduces the risk of rare but sight threatening complications that may occur during surgery or in the event of trauma to the eye following surgery. With this nearly sutureless technique, the eye is left much stronger and visual recovery is faster and better. For corneal transplants and DSAEK procedures: Surgery is performed on an outpatient basis and you go home within several hours. The actual surgery takes between 30 and 45 minutes, and is usually done under a local anesthetic. You will be given medication for sedation while your eye is completely numbed. You will be awake but relaxed throughout the procedure. A sterile drape will be placed over your other eye. During surgery you will be unable to move, blink or see out of your eye (faint shadows or dim light may be seen). After surgery, specific precautions will be reviewed. You will see your doctor post-operatively. At each visit you will be evaluated and updated on your progress. A typical visit schedule following surgery would be: Day one, week one, month one, every month for the first six months, and every few months for the remainder of the first year. There is usually no charge for exams during the first 3 months following surgery. Exams following the 3 months of post-operative care are usually filed to your insurance company.
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