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CORNEAL TRANSPLANT SURGERY

The cornea is the clear front surface of the eye that covers the iris and the pupil.  The cornea is approximately a half of a millimeter thick and accounts for about 2/3rds of the focusing power of the eye.  In most patients, the cornea remains perfectly clear.  In some patients, the cornea may be come scarred or may develop deposits within the center of the cornea.  In other patients, the cornea may become weak and develop an irregular shape (keratoconus or corneal ectasia).  In other patients, the cornea becomes progressively weak and may become swollen and cloudy. This commonly occurs in Fuchs' endothelial dystrophy.

Regardless of the cause of the corneal malfunction, severe cases of corneal opacities, irregularities, or edema may result in the need for a corneal transplant.  Cornea transplant tissue is donated by the recently deceased, and is screened for disease and tissue health prior to being approved for transplantation surgery.  As with any transplant, there is a risk of rejection, but the risk of rejection can be lowered using nothing more than eye drops.   Cornea transplant surgeons typically have received some additional training in the field of Ophthalmology to allow them to be able to perform Cornea transplants.

Most patients with corneal opacities or irregular shaped corneas would require a penetrating keratoplasty (commonly referred to as a PK or PKP).  In a PK, a circular section of defective central cornea is excised and similarly sized portion of donor cornea is sewn into place.  Post-operatively, sutures are slowly removed to reduce the amount of post-operative astigmatism.  In some cases, patients may be candidates for lamellar transplants (partial thickness).  Lamellar transplants are technically difficult, but often have a reduced recovery time and less chance of rejection.

Many patients with Fuchs' dystrophy or corneal edema can be managed with a type of lamellar transplant known as Descemets Stripping Endothelial Keratoplasty (DSEK).   DSEK has emerged as a favorite for transplant surgeons over the last 10 years as the recovery time and the risk ok rejection is lower than that of a typical PK.  In DSEK, the surgeon makes a smaller incision and strips out the defective inner portion of your cornea (endothelium).  Once removed a very thin transplant layer (about 1/10th of a 1mm) can be inserted into the eye and held into place using an air bubble.

Without a full consultation, it is impossible to know whether a corneal transplant (or which type) would be most appropriate for your eye.  Dr. Albright would be happy to see you and discuss with you all of the options for your eyes.  Please call to schedule today!

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