Which corneal transplant option is right for you?
Full-Thickness Corneal Transplant
Full-thickness Corneal transplantation (grafting) replaces the central 7-8 millimeters of the cornea with a donor cornea that has been prepared by an eye bank. The most common indications for undergoing a corneal transplant procedure are to improve vision, reduce pain, or to maintain the structural integrity of the eye. In the United States, the most common disorders treated with corneal transplantation include Fuchs’ dystrophy, corneal swelling following cataract surgery, keratoconus, and trauma-related corneal scarring.
Unlike cataract surgery, where visual recovery is rapid, the recovery time after a full thickness corneal transplant can take between 6 months to over one year before the best vision is obtained. Careful postoperative management is critical to ensure the success of the transplant. Postoperative management involves the use of eye drops to prevent infection and/or rejection of the transplant, reducing astigmatism of the transplant through timely suture removal, and monitoring for other complications such as glaucoma.
Unlike cataract surgery, where visual recovery is rapid, the recovery time after a full thickness corneal transplant can take between 6 months to over one year before the best vision is obtained. Careful postoperative management is critical to ensure the success of the transplant. Postoperative management involves the use of eye drops to prevent infection and/or rejection of the transplant, reducing astigmatism of the transplant through timely suture removal, and monitoring for other complications such as glaucoma.
Partial-thickness Corneal Transplant or 'DSEK'
When the inner most layer of the central cornea stops working properly, the cornea becomes cloudy over time. For the last 40 years, the only procedure to correct this problem was to replace the (entire) full thicknes of the cornea with a corneal transplant (PKP). Over the last several years, a revolutionary new procedure has been developed to replace only the innermost critical layer of the cornea. This procedure is known as DSEK (Descemet’s Stripping Endothelial Keratoplasty) or 'partial-thickness corneal transplant'. This procedure has tremendous advantages over its predecessor, i.e. the full thickness corneal procedure since the cornea heals much faster and stronger and the patient’s visual recovery is much quicker.
Because this technique uses only a single suture, it significantly improves the visual results and is often the preferred technique for patients with Fuchs’ dystrophy, bullous keratopathy and even failed full thickness corneal transplants. DSEK patients oftentimes can see 20/40 or better within the first 3 months of surgery and sometimes even 20/20.
The entire procedure usually takes less than an hour and is performed through a 1/4 inch incision requiring only a single suture in most cases. An air bubble is used to hold the donor tissue up against the posterior surface of the patient’s own cornea. The natural pumping action of the donor cornea quickly creates an adherence or “bonding” of the donor cornea to the recipient cornea.
In summary, DSEK offers patients much better and quicker visual recovery and a less protracted clinical course than standard PKP. It is a great alternative for almost all patients with only posterior corneal conditions such as Fuch’s dystrophy.
Because this technique uses only a single suture, it significantly improves the visual results and is often the preferred technique for patients with Fuchs’ dystrophy, bullous keratopathy and even failed full thickness corneal transplants. DSEK patients oftentimes can see 20/40 or better within the first 3 months of surgery and sometimes even 20/20.
The entire procedure usually takes less than an hour and is performed through a 1/4 inch incision requiring only a single suture in most cases. An air bubble is used to hold the donor tissue up against the posterior surface of the patient’s own cornea. The natural pumping action of the donor cornea quickly creates an adherence or “bonding” of the donor cornea to the recipient cornea.
- The eye is left much stronger and more resistant to injury
- Minimal change in refractive error due to fewer sutures
- Suture-related problems are negligible with much less astigmatism
- Visual recovery is significantly faster
In summary, DSEK offers patients much better and quicker visual recovery and a less protracted clinical course than standard PKP. It is a great alternative for almost all patients with only posterior corneal conditions such as Fuch’s dystrophy.
