Corneal Surgery
& Transplants

About Cornea Transplants

Corneal transplant is a type of eye surgery we perform to replace diseased, damaged, or scarred corneal tissue with new healthy corneal tissue. Since diseased, damaged, or scarred corneal tissue does not allow light to effectively pass into the eye and reach the retina, poor vision and even blindness may result from a damaged cornea.

There are several different types of corneal transplants that Corneal Specialist Jacquelyn Weber, M.D. performs.

Penetrating Keratoplasty
Penetrating Keratoplasty (PK) is a type of corneal transplant that involves the surgical removal of the central two-thirds thickness of the damaged cornea. We remove the central portion of the damaged or cloudy cornea with a “cookie cutter” like instrument called a trephine, and replace it with a clear cornea obtained from the eye bank.

Penetrating Keratoplasty

We then very carefully sew the donor cornea into place using sutures that are thinner than a human hair. To facilitate the healing of the newly transplanted cornea, we prescribe eyedrops for patients who have had corneal transplants. After the new cornea has healed properly, we will remove the fine sutures or stitches he put in place during the surgery. This type of transplant has the potential to provide the clearest vision after healing because there is no interface (layer) to look through. However, the healing time is longer, the risk of rejection exists and the use of a contact lens might be required for the clearest vision.

Descemet’s Membrane Endothelial Keratoplasty (DMEK)

Descemet’s Membrane Endothelial Keratoplasty (DMEK) is a type of corneal transplant that is a partial-thickness cornea transplant procedure that involves the selective removal of Descemet’s Membrane and Endothelium, followed by transplantation of donor corneal endothelium and Descemet’s Membrane without additional stromal tissue from a donor cornea. DMEK may be used for corneal diseases such as Fuchs Endothelial Dystrophy and Bullous Keratopathy.

Descemet’s Stripping Endothelial Keratoplasty (DSEK)

This type of Corneal Transplant is performed through a small incision, to remove and replace the inner cell layer of the cornea when it stops working properly. With this technique, we gently “strips” off the single diseased cell layer, called the Endothelium, and leave the remaining cornea intact. Using a prepared thinly sliced donor cornea from the eye bank we can fold the back portion in half and inserts it through a small incision into the eye. We then use an air bubble to unfold and position the donor tissue on the recipient cornea. Within a few minutes, the donor tissue attaches to the recipient without the use of any sutures. There are several advantages of DSEK if you are indeed a candidate:

  • Your eye remains much stronger
  • Visual recovery is very rapid
  • DSEK causes little change in eyeglass glasses prescription
Deep Anterior Lamellar Keratoplasty (DALK)
Deep Anterior Lamellar Keratoplasty (DALK) is a partial-thickness cornea transplant procedure that can be used when the innermost layers of the cornea Descemet’s Membrane and Endothelium are healthy but the outermost layers are diseased or damaged.

Deep Anterior Lamellar Keratoplasty (DALK)

More common uses of DALK include Keratoconus and Corneal Scars. In a DALK procedure, the Endothelium, or inner layer of the cornea is left intact and all other layers of the cornea are removed. Clear healthy donor tissue is prepared from a donor cornea and sutured in place over the recipient’s own endothelium. DALK offers the benefits of fewer postoperative complications, less risk of graft and tissue rejection, and a shorter need for topical anti-inflammatory medications such as steroids.

Corneal Transplants have become somewhat common in the United States as a treatment for damaged and cloudy corneas. Each year more than 40,000 people undergo corneal transplantation to restore their vision. If we find that other methods of treating your corneal disease or corneal condition are inadequate to give you good sight, we will fully discuss the risks and benefits of corneal transplantation and take the time necessary to answer all of your questions.