Fuchs’ Corneal Dystrophy and Other Corneal Dystrophies
Fuchs’ Dystrophy occurs when cells in the endothelial layer of the cornea begin to die off. These cells usually pump fluid out of the cornea to keep it clear. When these cells die, fluid builds up causing the cornea to swell and vision to become blurry and cloudy. Read more about Fuchs’ Dystrophy here: https://www.aao.org/eye-health/diseases/what-is-fuchs-dystrophy
There are more than 20 different types of corneal dystrophies. Read more about them here: https://www.aao.org/eye-health/diseases/corneal-dystrophies
Eye infections, injuries, or previous surgery on the eye can cause corneal scarring. Different options, surgical and non-surgical, may be available depending on your diagnosis. A thorough eye examination by a corneal specialist can help you determine what treatment or option is best for you.
Corneal Transplant Surgery
Corneal transplant surgery involves removing the damaged or diseased cornea from the eye and replacing it with a healthy cornea. There are now several different options when it comes to corneal transplant surgery; full thickness Penetrating Keratoplasty (PK), partial thickness Descemet’s Stripping (Automated) Endothelial Keratoplasty (DSEK/DSAEK), and the newer partial thickness Descemet Membrane Endothelial Keratoplasty (DMEK). During the full thickness transplant, a healthy cornea, which comes from a donor, is sewn in place during the surgery. Over time vision will improve, but the process can be long as the new full thickness cornea heals into place. Partial thickness transplants are ideal for patients that only need the Descemet’s membrane and damaged endothelial cells removed and replaced with healthy donor tissue. These partial thickness transplants leave the surface of the cornea untouched and the cornea heals into place by inserting an air bubble behind the cornea. It is required of the patient to lay flat on their back in an 180-degree plane for 24-48 hours as directed by the surgeon. With the DSEK/DSAEK, vision recovery is much quicker and outcomes are better than a full thickness graft. DSEK/DSAEK donor cornea includes 3 layers of tissue, while the more advanced DMEK is thinner and only includes 2 layers of tissue. The new DMEK procedure has a lower rate of rejection, smaller incision, and better potential vision after surgery. Depending on your condition, the surgeon will recommend the best treatment and surgical plan for you.
For a successful outcome, it is important to attend ALL scheduled appointments and follow ALL post-operative instructions. Occasionally, corneal transplants can reject which causes the cornea to cloud, the eye may turn red, and the vision to deteriorate. To prevent rejection, patients are kept on a once a day prophylactic eye drop. Patients are encouraged to call as soon as they begin to notice significant decreases in vision, in which the doctor can prescribe stronger eye drops to decrease rejection.
Christopher S. Ketcherside, M.D. is our fellowship trained corneal specialist in the surgical treatment of corneal disorders including extensive experience with full thickness transplantation and partial thickness transplantation. Click here to request an appointment or call 913.341.3100 to schedule an evaluation.