Cornea Services

Advantages of DSEK

 

  • Stronger wound, resistant to trauma.

  • Astigmatically neutral.

  • Corneal nerves preserved.

  • Faster rehabilitation with vision comparable to PK.

  • No suture related complications.

             

DSEK Transplant no sutures and small air bubble which dissolves in 48 hours after surgery

 

 

 

 

 

Corneal Transplants

 

The cornea is the clear covering of the front of the eye which bends light rays that focus on the retina in the back of the eye. Whenever the shape or clarity of the cornea is altered the patient experiences a loss of visual acuity. Although there are numerous disease of the cornea the two primary conditions that cause visual disturbance are keratoconus and Fuch's dystrophy. There have been numerous advances in corneal transplant surgery over the last few years and Dr. DeCarlo will review all your options with you at the time of your examination.

 

 

 

 

Fuchs' Corneal Dystrophy

 

Fuchs’ Corneal Dystrophy is a slowly progressing disease that occurs when endothelial cells lining the inside of the cornea begin to die off. The disease generally affects people over 50, although early signs of the disease may be evident in the thirties or forties. There is no known cause of Fuchs’ dystrophy, but often the disorder is inherited. Fuchs’ dystrophy tends to affect women more than men and generally involves both eyes. The disease is one of the leading causes of corneal transplant surgery.

The cornea is the clear, dome-shaped outermost layer of the eye responsible for refracting light. It consists of five primary layers: the epithelium, Bowman’s layer, the stroma, Descemet’s membrane and the endothelium. Normally, the endothelium, or the delicate innermost layer, acts like a pump, moving fluid out of the stroma. In Fuchs’ dystrophy,cells in the endothelium gradually deteriorate, and the pumping action becomes less efficient. When this happens, the cornea begins to swell and cloud, and vision is distorted. As the disease progresses, the endothelium may begin taking on water, causing further vision loss and pain.

Generally, doctors treat early stages of Fuchs’ dystrophy with drops, ointments and/or contact lenses to reduce corneal swelling. However, as the disease progresses, vision impairment may begin to affect the patient’s quality of life. In this case, corneal transplant surgery offers the best hope for restoring vision. For the past few years Dr DeCarlo has been one of only a few corneal surgeons in the US to perform the new DSEK procedure for this disease. This technique allows for a much quicker visual recovery. He is the first surgeon to introduce this technique at St Luke's Regional Medical Center and has mentored three corneal surgeons as they become comfortable with the technique.