Corneal Disease and Treatment

The cornea is the clear front window of the eye. It transmits light to the interior of the eye allowing us to see clearly. Corneal disease can be a serious condition that can cause clouding, distortion, and even blindness. There are many types of corneal disease. Three common causes of corneal disease are keratoconus, Fuchs’ endothelial dystrophy, and scarring from injury or infection.

As with any serious eye infection, corneal disease should be treated immediately. While a corneal transplant can sometimes be a necessary treatment to restore vision when the cornea becomes clouded, there are other measures that can be taken to prolong vision in the early stages of disease. An estimated 20,000 corneal transplants are performed each year in the United States. Today, partial thickness transplants, DSEK or DMEK, have become the most common type performed, and can even be performed at the time of cataract surgery.

Treatment Overview

Descemet’s stripping endothelial keratoplasty, or DSEK, is a partial thickness corneal transplant that requires a thin piece of donor tissue to be placed on the back surface of the cornea. Prior to the development of DSEK, the only options for patients with reduced vision or blindness due to corneal disease was complete corneal transplant. During a DSEK, or the even thinner DMEK procedure, only the innermost layer of the cornea, the endothelium, is transplanted, reducing incision size and recovery times.

Realistic Expectations

Return of best vision after corneal transplant surgery may be recognized in as little as 2 weeks for DMEK, while it may take up to a year after a full thickness transplant. The success rate for corneal transplants depends on the cause of the clouding. If your doctor decides that a corneal transplant is an option for you, you will be given additional information that will allow you to make an informed decision about whether to proceed.

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