Corneal transplants are used to treat the following conditions:
- Corneal failure after another eye surgery
- Hereditary corneal failure
- Scarring after infection or injury
- Rejection after a previous corneal transplant
There are several types of corneal transplants, and a thorough medical eye history and evaluation is needed to determine which is best suited to your needs.
DMEK (Descemet Membrane Endothelial Keratoplasty) is a highly advanced partial corneal transplant procedure. It is recommended in diseases affecting the innermost layer of the cornea, the endothelium. In DMEK surgery, a single, thin layer of healthy endothelial cells from a donor is used to replace the damaged endothelial cells in your eye. This creates an exact anatomical replacement of the damaged cells. With this procedure, there are significantly decreased rates of rejection and faster visual recovery. DMEK best treats diseases that cause corneal swelling by affecting the innermost layer of the cornea including:
- Fuchs’ endothelial dystrophy
- Posterior polymorphous membrane dystrophy
- Congenital hereditary endothelial dystrophy
- Bullous keratopathy
- Iridocorneal endothelial (ICE) syndrome
- Failed corneal transplants
DSAEK (Descemet Stripping Endothelial Keratoplasty) is a partial cornea transplant similar to a DMEK but the tissue graft is slightly thicker compared to a DMEK graft. This surgery is used to treat patients with corneal swelling or edema and is a good option for people who have complicated eye disease with prior history of other eye surgeries. This procedure inserts the new cornea through a small incision that requires only a few sutures for closure while the graft is supported by an air bubble until it stabilizes. Benefits include shorter post-op recovery, faster visual recovery, less chance of rejection and less invasive repeatability.
Penetrating keratoplasty (PKP) is a full-thickness corneal transplant or corneal graft. This procedure requires removing the entire central cornea that is diseased and replacing it with a new, healthy cornea from a human donor. The new cornea is sutured in to place with multiple sutures. The healing time is months to years and patients will have to use steroid drops indefinitely to prevent rejection. Candidates for PKP include those who have the following conditions:
- Corneal edema, ulceration, or dystrophy
- Traumatic injury
- Bacterial, fungal, viral, or protozoan infection
- Rejection of previous graft
Pterygium surgery is performed to remove an abnormal tissue growth from the sclera and cornea of the eye. Dr. Salisbury performs this surgery using a conjunctival autograft which reduces the risk of reoccurrence. During the procedure, the pterygium is removed, and the conjunctival autograft is glued in to place. The cornea regains clarity and will improve the cosmetic appearance of the eye as well as decrease astigmatism. A no-stitch pterygium/autograft surgery allows most patients to return to work within one or two days of surgery.