Corneal Surgery
Pterygium Surgery
This surgery involves removal of an abnormal growth of the conjunctiva (pterygium) and replacement with a graft of your own conjunctival tissue from the upper part of your eye or an amniotic membrane graft. This is secured in place with fibrin glue and/or sutures. Surgery usually takes 30-45 minutes. After surgery a patch and shield will be placed over the eye. It is normal to experience irritation, redness, and blurry vision after surgery. Placement of a graft can help prevent recurrence but it is possible that the pterygium recurs and requires repeat surgery.
Descemet’s stripping automated endothelial keratoplasty (DSAEK)/Descemet’s membrane endothelial keratoplasty (DMEK)
DSAEK and DMEK are both partial thickness corneal transplants that involve removal and replacement of the inner layer of the cornea. The goal of these surgeries is to replace the damaged endothelial cells that are responsible for pumping fluid out of the cornea. Indications for surgery include Fuchs’ Dystrophy, Aphakic/Pseudophakic bullous keratopathy, or any disease affecting the endothelial cell layer of the cornea. In both of these procedures, the patient’s Descemet’s membrane (the innermost membrane of the cornea) is peeled off and replaced with a partial thickness donor graft containing healthy endothelial cells. In DSAEK the graft is thicker and includes part of the stromal (middle) layer of the cornea as well as the Descemet’s membrane and endothelium. In DMEK the graft is thinner and includes only the Descemet’s membrane and endothelium. An air or gas bubble is then placed in the eye to help hold the graft in place. The surgery usually takes less than an hour. After surgery, it is important to maintain face-up positioning for the first few days. These surgeries are less invasive and the recovery time is much quicker than for a full thickness transplant.
Penetrating Keratoplasty (PKP)
A penetrating keratoplasty is a full-thickness corneal transplant. This surgery is indicated in patients with diseased corneas such as due to scarring or thinning. In this surgery, a “button” of cornea tissue is removed and replaced with a “button” of donor corneal tissue. This tissue is secured in place with multiple fine sutures. These sutures stay in place until they gradually start to be removed several months after surgery. Full recovery from the surgery can take 6-12 months.
