Cornea Care in Wilmington – Delaware Eye Surgeons
The cornea is the clear, outermost part of the eye, covering the iris, pupil and anterior chamber. This dome-shaped structure refracts, or bends, light onto the retina. Together with the eye’s natural crystalline lens, it is responsible for focused vision. The cornea is extremely sensitive and has more nerve endings than any other part of the human body. In order to refract light properly, the cornea must remain transparent. Any cloudy or opaque areas may interfere with this process and affect vision.
The corneal tissue is made up of five essential layers:
- Epithelium – the cornea’s outermost region
- Bowman’s layer – transparent tissue composed of collagen
- Stroma – the thickest layer of the cornea, consisting of water and collagen
- Descemet’s membrane – a protective sheet of tissue made up of collagen and endothelial cells
- Endothelium – the innermost layer of the cornea, made up of endothelial cells; it is essential for keeping the cornea clear
The cornea can be affected by many diseases, medical conditions and traumatic injury. A severely damaged cornea may lead to complete vision loss. In such cases, a corneal transplant is the only treatment option.
A corneal transplant can be used to treat a number of conditions, including:
- Keratoconus (a cornea that bulges outward)
- Fuch’s dystrophy (thinning of the cornea)
- Corneal scarring due to infection or injury
- Clouding of the cornea
- Swelling of the cornea (pseudophakic bullous keratopathy)
- Corneal ulcers
- Graft failure after previous corneal transplant surgery
At Delaware Eye Surgeons, Dr. Gregory Smith and his medical team offer two types of corneal transplant surgery:
- Standard Penetrating Keratoplasty
- Descemet’s Stripping Endothelial Keratoplasty (DSEK)
Corneal Transplant Surgery in Wilmington – Delaware Eye Surgeons
Corneal transplant surgery (keratoplasty) is performed to replace the patient’s cornea with a healthy cornea from a donor, which is obtained from an eye bank.
When performed under the care of skilled Delaware Eye Surgeons, a corneal transplant can restore vision and reduce discomfort associated with corneal diseases and conditions, thereby improving patients’ quality of life.
Standard Corneal Transplant Surgery
A standard, or full-thickness, transplant involves the surgical removal of the central corneal tissue, which is then replaced with healthy donor tissue and secured in place with sutures. The procedure is performed on an outpatient basis under local anesthesia.
Recovery time following standard corneal transplant surgery may last up to 12 months, during which time our Wilmington cornea transplant patients are provided with medicated eye drops and antibiotics and must wear an eye shield to prevent injury to the newly placed cornea. Frequent eye exams are essential to the success of the procedure.
Although full-thickness corneal transplantation is a relatively safe procedure, it is associated with rare but serious complications, including rejection of the donor cornea, in which the body’s immune system mistakenly attacks the donor tissue.
DSEK Corneal Transplant Surgery
Whenever possible, Dr. Smith prefers to perform the advanced DSEK corneal transplant surgery. Unlike full-thickness corneal transplant surgery, the DSEK procedure involves the surgical replacement of only the damaged inner layers of the cornea. In this technique, the back layer of the cornea is removed and replaced with a thin piece of donor tissue through a small incision in the eye. The donor tissue is secured in place with an air bubble that is injected into the eye to push and hold the new tissue in place. The incision is closed with one small suture.
Compared to standard corneal transplant surgery, the less-invasive DSEK procedure has several advantages, including:
- A smoother corneal surface
- Stronger corneal integrity
- Fewer sutures
- Faster recovery (several weeks versus several months)
- Reduced chance of donor tissue (graft) rejection
- Decreased risk of suture complications and wound infections
- Quicker vision improvement
Full recovery following DSEK is usually achieved within a few weeks.
Corneal Transplant Surgery Candidacy
A thorough eye exam is necessary to determine each patient’s candidacy for corneal transplant surgery. In general, the patient’s candidacy greatly depends on his/her medical history and any additional eye diseases and conditions. Unrelated eye problems such as inflammation or infection may interfere with the success of the corneal transplant.
DSEK corneal transplant surgery is only suitable for patients whose corneal problems involve the inner most layer of the cornea (endothelium).
Please contact our practice at (302) 993-1300 to schedule your corneal transplant surgery consultation or use our online appointment request form.