Cornea transplantation is the most frequently performed transplant worldwide. Approximately 40,000 cornea transplants are performed in the United States annually. The cornea is the front surface of the eye and is responsible for two-thirds of the focusing power of the eye. It is primarily made of layers of collagen in ordered rows that allow light to pass through. Injury, infections and disease can cause the cornea to lose its transparency and result in a loss of vision. Corneal transplants have traditionally involved surgically removing the central diseased portion of a patient’s cornea and replacing it with a full-thickness donor cornea obtained from a recently deceased individual whose corneas have been stored in an eye bank. This is performed as outpatient surgery and takes anywhere from 40 minutes to an hour or more depending upon what else needs to be done such as cataract removal, intraocular lens implantation, or repair of the iris. Recovery of best vision usually takes four to six months. The patient has a life-long risk of graft rejection. The main disadvantages to this surgery are the introduction of astigmatism and the unpredictability of the eye’s refractive error afterwards. This is because the curvature of the donor cornea is unknown prior to surgery and the corneal curvature greatly affects the eye’s refractive error.
Over the last two years a newer cornea transplantation techniques have been evolving in which only the diseased layer of the cornea is being replaced instead of the entire cornea thickness. The most successful of these new procedures is called Descemet’s stripping endothelial keratoplasty or “DSEK” (pronounced “Dee-sek”). This technique is used when only the inner lining of the cornea needs replacing. The diseased inner lining of the patient’s cornea is removed and the inner lining of a donor cornea is inserted into the eye folded like a taco through a small incision. An air bubble is used to unfold the donor cornea and push it up against the patient’s own cornea to make it stick. This is done without sutures! The result is that the patient recovers vision typically within two to three months and very little astigmatism is induced. This has been shown to be a much more predictable procedure and we have been performing this procedure successfully for the past two years.
As a fellowship-trained cornea specialist, I have been performing cornea transplants for 17 years. Feel free to call our office to schedule a consultation at 661-259-3937or send me an email at craighelm@sbcglobal.net .