Did you know that the cornea accounts for almost 2/3 of the complete optical power of the eye? The ability of the eye to focus mostly comes from the power of the cornea. There are various treatment options to improve the shape of the cornea and ultimately improve vision. Surgical procedures are designed to reshape the cornea and reduce the need for glasses or contacts.
Descemet's Stripping with Endothelial Keratoplasty (DSEK)
Descemet's Stripping with Endothelial Keratoplasty is a newer corneal transplant technique that replaces only the damaged cell layer instead of replacing the entire thickness of the cornea. This technique allows the cornea to heal much faster and stronger, resulting in an enhanced recovery for the patient.
DSEK leaves a smoother interface and significantly improves the visual results which is why many patients choose to undergo this surgery for a damaged cornea. With the DSEK procedure, a thin circular disk is removed from the inner lining of a donor cornea. The disc is then folded and placed inside the damaged eye where air bubbles help to push the disc into an appropriate position to heal. There are no sutures required for the DSEK procedure which takes approximately 45 minutes under local anesthesia.
For the first 24 hours after surgery you will be asked to lie on your back with your face pointed directly to the ceiling for as much time as you can tolerate. This will help the graft stay in position as the air bubble holds it up into place on your cornea. You will be given several drops to use to prevent infection as well as to help the eye heal comfortably. After the first 48 hours there are minimal restrictions to your activities. The vision is usually better within one week and by one month 80% of the healing has taken place. In the months to follow, vision should progressively improve.
Penetrating Keratoplasty (PKP)
Penetrating Keratoplasty is a procedure which involves replacing the scarred or damaged cornea of the eye with the tissue of a donor's clear cornea. PKP is a great option for those patients who suffer from decomposition of the cornea, corneal scarring or trauma, and corneal dystrophy.
During this procedure, Dr. Schmidt will remove the damaged cornea and replace it with a new cornea from a donor. PKP does require sutures to secure the donor cornea, however, the sutures are ultra-fine (approximately 1/3 the thickness of human hair) and are removed about one year later.
In the months following surgery, vision should stabilize and gradually improve. It is important to note, however, that with any surgery, every patient will heal at a different pace.