The cornea is one of the most versatile parts of the human body. It protects the highly sensitive underlying structures of the eye from germs and debris, but it is also plays a role in the focusing of the eye, and is essential for clear vision. Diseases and disorders that affect the cornea can therefore not only be painful but also result in impaired vision. Fortunately, modern ophthalmology offers a variety of treatment options, including laser and cornea transplants. Our Wilmington, Delaware practice is one of only a few in Delware to offer fellowship trained corneal expertise. Dr. Jeffrey Minkovitz, who completed a cornea and refractive surgery fellowship at the Wilmer Eye Institute, was not only the first Delaware surgeon to perform excimer laser vision correction (PRK), but he was also the first to regularly offer the newer, safer DSAEK and DALK corneal transplant procedures (see below). Dr. Minkovitz would be pleased to evaluate your condition and personally advise you of the treatment options that are best suited to you.
At Eye Physicians and Surgeons, P.A., we offer treatments for the following corneal conditions, among others:
- Fuchs’ Dystrophy
- Bullous Keratopathy
- Corneal Ulcers
Our treatment options include:
- Cornea Transplants
- Descemet’s Stripping (Automated) Endothelial Keratoplasty (DSAEK)
- Deep Anterior Lamellar Keratoplasty (DALK)
- medical therapy with topical eye drops
- laser removal of scarring
- superficial keratectomy (in the office)
Fuchs’ Dystrophy is a progressive corneal disease in which fluid is retained by the cornea. In the earliest stages of the disease, this fluid drains over the course of the day, so that people who wake up with cloudy vision find their condition improving during their waking hours. As the disease progresses, however, this corneal swelling becomes more persistent and can cause a person to experience blurry vision throughout the day. While there are topical treatments that can temporarily relieve symptoms of Fuchs’ Dystrophy, surgery is the only option for permanent relief. Both DSAEK and cornea transplants have proven to be highly effective at our Wilmington office.
Bullous keratopathy is a corneal disease characterized by a severe swelling of the cornea. People affected by this disease develop blisters on the surface of the cornea. When these blisters drain, the release of fluid can be painful, as well as harmful to vision. Fortunately, corneal transplantation offers a permanent solution to this condition.
Keratoconus is a degenerative corneal disorder in which the structure of the cornea becomes thin and cone shaped, severely distorting vision and making the patient sensitive to light. Typically affecting those in their 20s and 30s, symptoms can begin as early as the teens. Though vision is initially corrected with special contact lenses or glasses, eye surgery may become necessary as the disorder progresses. Surgical procedures available at our Wilmington, Delaware practice include cornea transplants and radial keratotomy (RK).
Keratitis is an inflammation of the cornea that can affect the cornea’s outermost layers as well as its deeper layers. There are a variety of possible causes of keratitis, including the Herpes simplex virus, bacterial or fungal infections, a severe allergic response, and the use of extended-wear contact lenses. The proper treatment of the condition depends largely on its cause; in many cases, antibacterial, antifungal, or antiviral therapy can be effective. However, when keratitis affects the deeper corneal tissues, scars and perforations can occur, leading to impaired vision. In such cases, corneal surgery may be the best option.
Corneal ulcers commonly develop as a result of injury, allergy, dry eyes, or infection; however, irritation caused by contact lenses can also lead to their development. Typified by redness, discharge, and moderately impaired vision, corneal ulcers are often relatively easy to treat if brought to the attention of our eye doctors in their earliest stages. Topical treatments are particularly effective in treating ulcers caused by bacterial infections. However, corneal ulcers that affect the deeper layers can cause scarring and, therefore, vision loss. By making an appointment at Eye Physicians and Surgeons, P.A., at the outset of your symptoms, you can be assured of a proper diagnosis of your condition, as well as the best course of treatment.
Of all transplant surgeries, none is safer or more consistently successful than corneal transplantation. By replacing a damaged cornea with a healthy one, an eye surgeon is able not only to relieve pain and restore vision, but also to save a patient from future vision loss. The procedure has helped hundreds of thousands of people to see the world through fresh eyes.
Corneal transplant surgery typically takes between one and two hours to complete. The procedure begins with the application of anesthetic drops that numb the eye. A precise portion of the diseased cornea is removed and then replaced with healthy corneal tissue. This healthy donor tissue has been carefully screened for the protection of the recipient. Once the healthy tissue is in place, it is sutured, and the surgery is complete.
Over the weeks that follow, the eyes are carefully monitored to ensure proper healing. Vision improves gradually but steadily, with full visual acuity returning over the course of months. During this period, most patients are able to resume most of their normal activities. Once the stitches have been removed, patients can improve their vision with a new eyeglass prescription or, in some cases, even LASIK or PRK.
For further information about cornea transplants, please contact our Wilmington, Delaware vision correction center.
Descemet’s Stripping (Automated) Endothelial Keratoplasty (DSAEK), also called DSEK, is a surgical technique performed to replace a portion of a diseased cornea with healthy tissue from a recently deceased donor. Though ideal for patients suffering from Fuchs’ Dystrophy, it can be performed on patients with other corneal diseases as well. A conservative eye surgery, DSAEK replaces only the damaged corneal cells located in the endothelial (back) portion of the cornea, instead of the entire cornea. Associated with fewer complications and faster healing, this technique allows Dr. Minkovitz to perform the procedure with extraordinary precision and consistently excellent results.
Deep anterior lamellar keratoplasty is a new method of corneal transplantation that selectively removes the diseased front portion of the cornea and retains the healthy innermost layer (endothelium). This procedure is, therefore, safer as it does not require a large opening in the eye, and avoids the risk of rejection of the critical endothelial layer. Eyes may heal faster, and are somewhat less susceptible to injury. Dr. Minkovitz was the first surgeon to successfully perform DALK in Delaware.