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Diabetic Retinopathy - Cornea - Fuchs' Dystrophy
DSAEK - Glaucoma - Keratoconus - Aesthetics
Cornea
 The cornea is a thin, clear, spherical layer of tissue on the surface of the eye that provides a window for light to pass through. In a healthy eye, the cornea bends or refracts light rays so they focus precisely on the retina in the back of the eye.
There are many diseases that can affect the cornea, causing pain or loss of vision. Disease, infection or injury can cause the cornea to swell (called "edema") or degrade (become cloudy and reduce vision). Common diseases and disorders that affect the cornea include:
- Allergies
- Conjunctivitis ("Pink Eye")
- Dry Eye
- Corneal Dystrophies including Fuchs' Dystrophy and
Lattice Dystrophy
- Glaucoma (High Eye Pressure)
- Infections
- Keratitis (Viral Inflammation)
- Keratoconus
- Ocular Herpes
- Pterygium
- Shingles (Herpes Zoster)
- Stevens-Johnson Syndrome
Treatment for corneal disease can take many forms, depending on the underlying problem as well as the patient's preferences. Some conditions resolve on their own and many can be treated with medication. If the cornea is severely damaged or if there is a risk of blindness, a corneal transplant may be recommended to preserve vision.
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Fuchs’ Dystrophy
 Fuchs’ dystrophy is an inherited eye disease that causes the cells in the endothelium, the last layer of the cornea, to deteriorate. This leads to distorted vision and corneal swelling. The exact cause of Fuchs’ dystrophy is unknown, but is believed to be a combination of hereditary, hormonal and inflammatory factors. This condition affects both eyes and is more common in women than in men.
The cornea is made up of five different layers, each of which has a specific function that controls vision. The endothelium is the back layer of the cornea, which removes excess fluid from the cornea. Excess fluid can cause the cornea to swell and vision to become distorted. Occasionally the swelling can become so severe that bullae (blister like lesions) will develop that can result in pain. Once endothelial cells are lost, they do not grow back, so this condition will continue to progress with time.
Symptoms
Although this condition is inherited, symptoms do not usually appear until the patient is over the age of 50. Patients with Fuchs’ dystrophy may experience blurred vision as the first sign of this condition. Blurred vision occurs as a result of fluid accumulating in the cornea while you sleep. As this fluid evaporates throughout the day, vision will improve. Other symptoms of Fuchs’ dystrophy may include:
- Sensitivity to bright lights
- Halos around lights
- Poor night vision
- Sharp pains in the eyes
- Sandy, gritty sensation in the eyes
- Fluctuating vision
Treatment
While there is no cure for Fuchs’ dystrophy, there are several treatment options available to help relieve the symptoms of this condition and to prevent permanent
damage. In its early stages, Fuchs’ dystrophy can often be treated with a salt solution to remove fluid from the eye and reduce swelling. Patients can also relieve excess fluid in the cornea by holding a hair dryer at arm’s length and blowing air towards the face. These methods are often successful in temporarily improving vision during the early stages of Fuchs’ dystrophy.
In more advanced stages, Fuchs’ dystrophy may begin to interfere with daily activities and prevent patients from functioning normally. In this stage, patients may require a corneal transplant to replace the cornea with full, thick layers that allows them to see clearly. Dr. Dean Dornic of Eye Specialists of Carolina is one of the few ophthalmologists in the country experienced in the DSAEK procedure. The DSAEK procedure is an innovative, new, partial corneal transplant procedure performed on an out-patient basis. Patients are more comfortable after a DSAEK procedure because it can be performed without sutures. The DSAEK procedure is also safer than a traditional corneal transplant and leads to a quicker, more complete vision recovery.
DSAEK (Partial Cornea Implants)
 Corneal transplants have restored vision to thousands of patients who have suffered vision loss from corneal disease, infection or injury. Recently an innovative new technique: Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) has allowed for transplantation of the rear or endothelial only layer of the cornea. The advantage of DSAEK over a full corneal transplant is that there is little change in the shape of the cornea and therefore less change in the patient’s prescription. This means that the patient is less likely to need special contact lenses to see properly after surgery. There are also less sutures which results in more comfort during healing and a lower likelihood of infection. Vision recovery is also much quicker and organ rejection is less likely to occur. The bottom line is that DSAEK is the preferred method to correct vision loss from certain eye disease because it is safer, success rates are higher and vision recovery is quicker.
To perform DSAEK, the surgeon cuts and prepares the donor cornea. Next, he or she makes a mark in the surface of the patient's cornea with a trephine (an instrument used to cut circular sections of tissue). That mark serves two purposes: it helps the surgeon determine what size the transplant should be, and it outlines the area of the patient's cornea that needs to be peeled away.
Next, the surgeon scores the damaged section of the cornea and strips the membrane away from the eye. Then the donor cornea is folded into a "taco" shape and placed in the eye. A single stitch closes the incision. Patients are sent to the recovery room for about one hour then allowed to return home. Patients are then given antibiotics and steroid eye drops and will return the next day for a follow-up appointment.
For more information about DSAEK , please click here »
LASIK - iLASIK - PRK - CK - ICLs - Cataracts - IOLs
ReSTOR® - ReZoom™ Lens - Crystalens™
Diabetic Retinopathy - Cornea - Fuchs' Dystrophy
DSAEK - Glaucoma - Keratoconus - Aesthetics
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