Corneal Procedures
Treatment for Corneal Diseases
When corneal diseases damage the eye, there are a number of treatments available at Cape Fear Eye Associates to help restore vision. Our ophthalmologists perform phototherapeutic keratectomy (PTK) laser surgery to correct superficial corneal irregularities. We also offer corneal transplant surgery (keratoplasty) for patients with more severe corneal damage.
PTK (Phototherapeutic Keratectomy)
Using an excimer laser, our ophthalmologists in North Carolina can treat many forms of superficial corneal damage caused by infections, dystrophies, and other vision problems. To remove superficial roughness or cloudiness of the cornea, the pulsed ultraviolet radiation of the excimer laser evaporates the outer layers of the cornea without damaging surrounding tissue. The result is a smoother corneal surface and improved vision. Compared to surgery with a blade, PTK with the excimer laser is incredibly accurate and involves minimal risk of scarring.
Following the procedure, our ophthalmologists apply topical antibiotics and anti-inflammatory medication to reduce the risk of infection and promote healing. A patch is then placed over the eye to protect it from dust particles and bright light. Patients are able to leave immediately following surgery, but they will need someone to drive them home. There may be some minor discomfort in the days following surgery, in which case over-the-counter analgesics usually provide sufficient relief.
Corneal Transplant (Keratoplasty)
A corneal transplant is used to treat severe corneal damage caused by Fuchs’ dystrophy, corneal edema, keratoconus, herpes simplex, shingles, trauma, and various other corneal diseases. During keratoplasty, damaged corneal tissue is removed and replaced with healthy donor tissue in order to minimize the effects of eye disease.
A very precise form of surgery, a corneal transplant is performed under a surgical microscope. Using a special surgical instrument, ophthalmologists first remove the damaged area of the cornea. Next, precisely cut donor tissue is transplanted and stitched into place with ultrafine nylon sutures.
Following surgery, your treated eye is covered with a soft eye patch as well as a hard eye shield. Patients will need to arrange for someone to drive them home, as vision is temporarily impaired after corneal transplant surgery.
The procedure takes one to two hours, depending on each person’s needs. It is performed on an outpatient basis while the patient is under local or general anesthesia. For patients with more complex eye disorders, our ophthalmologists often combine corneal transplant surgery with cataract surgery and the placement of intraocular lens implants.
DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty)
DSAEK is the next-generation corneal transplant. Indicated for diseases of the corneal endothelium such as corneal edema and Fuchs’ Dystrophy, DSAEK preserves up to 95 percent of the cornea, depending on the nature of the patient’s disease. It is therefore considered a “cornea-sparing” procedure.
The DSAEK procedure entails the removal of damaged endothelial corneal tissue and replacement with donor tissue. After the eye is anesthetized, an incision is made in the eye, and a special instrument is used to remove a circular portion of the diseased inner layers of the patient’s cornea. The donor tissue is then cut, prepared, and then inserted into the eye. An air bubble is used fill the front of the eye and enables the new tissue to adhere to the surrounding cornea. Part of the air bubble is released either at the end of surgery or one hour later. The patient will return the following day so that one of our ophthalmologists can check the tissue’s position and make any corrections that are necessary.
Unlike a traditional corneal transplant, DSAEK requires no stitching and prevents significant astigmatism from developing postoperatively. It also provides for quicker visual recovery and healing, taking only a few months instead of a year. Following DSAEK, the cornea is more stable, structurally stronger, and more resistant to injury compared to after a full-thickness corneal transplant. DSAEK also reduces the risks associated with traditional corneal transplant, such as hemorrhaging and vision loss. DSAEK is not right for everyone. Only experienced ophthalmologists can determine whether DSAEK is the appropriate treatment for your specific corneal problem.
Contact Our Ophthalmologists for Treatment of Corneal Diseases
If you are experiencing pain, redness, blurred vision, or excessive tearing of the eyes, you may have a corneal disorder. Our ophthalmologists in North Carolina can provide you with an exam, an evaluation, and treatment for your condition. Contact Cape Fear Eye Associates today to schedule an appointment.