Cornea Surgery: What You Need to Know

Did you know that cornea transplants are the most commonly performed type of transplant surgery in the United States? In 2023, the number of transplants performed in the U.S. surpassed 130,000. As impressive as that number is, you’d be surprised to know just how many people aren’t familiar with the procedure or why it’s necessary. Read on for a closer look at cornea surgery and the special circumstances that call for it.

Cornea Treatments 101

The cornea is the clear, dome-shaped layer on the front of your eye. It acts like a lens, bending (refracting) light rays as they pass through your eye and channeling them on your retina. The retina then converts the light into electrical signals that are transmitted to the brain, allowing you to see clearly.

At Vance Thompson Vision, we start with a consultation to discuss your symptoms, personal and family medical history, and perform several diagnostic screenings to determine which treatment option is the best fit for you.

Corneal Cross-Linking

Our corneas contain cross-links between collagen fibers in order to maintain their shape and strength. When there aren't enough cross-links, this causes the cornea to become irregularly shaped, unstable, and weak. Corneal cross-linking is a procedure that halts disease progression and reinforces corneal stability, helping to strengthen and preserve your vision.

Cornea Transplant

Depending on the severity of your cornea’s condition, your doctor may recommend a cornea transplant. During a cornea transplant, your surgeon replaces your damaged cornea with donated, healthy corneal tissue, restoring your ability to see and improving your quality of life. There are different types of cornea surgeries depending on which layer of your cornea is the most damaged:

Full-Thickiness Transplant (Penetrating Keratoplasty)

In this procedure, the surgeon removes the entire center part of the damaged cornea and replaces it with a healthy, same-shaped piece of donor cornea.

Partial-Thickness Transplant (Deep Anterior Lamellar Keratoplasty)

This surgery is beneficial if the damage lies in the middle and outermost layers of your cornea. The surgeon removes those two layers and replaces them with healthy donated corneal tissue.

Endothelial Keratoplasty

This minimally invasive cornea transplant surgery benefits the innermost layer of your cornea (the endothelium). This type of procedure can be performed with two different types of surgeries.

• Descemet’s stripping automated endothelial keratoplasty (DSAEK)
• Descemet’s membrane endothelial keratoplasty (DMEK)

Both procedures involve the surgeon removing the damaged innermost layer and replacing it with healthy donor tissue. The difference between these two surgeries is the type of donor tissue used. DSAEK is thicker, while DMEK is thinner. The decision of which to go with comes down to a conversation between you and your surgeon.

Why You Would Need Cornea Surgery

You doctor may suggest cornea treatment if you have:

• Keratoconus - A condition in which your normally round cornea becomes more cone-shaped, making your vision less sharp and causes you to become more nearsighted.
• Fuchs’ Dystrophy - With this disease, certain cells in your corneas die off, causing your cornea to swell with fluid. This causes blurry vision and, without treatment, can result in vision loss.
• Corneal Ulcers - When the cornea becomes infected it is called a corneal ulcer. Ulcers can  cause severe permanent vision loss and may even lead to  blindness. Vision can sometimes be restored with a cornea transplant.
• Injury/Trauma - The cornea can be damaged and scarred from unintended eye injuries and frequent eye rubbing. Not protecting your corneas may require cornea transplantation to restore vision. 

What can you do?

While there are some things that can’t be prevented, the majority of cornea disease we treat can be by these simple steps:

1. Eye Exams: We recommend a routine eye exam with your local optometrist every 1-2 years to catch corneal diseases early which allows for earlier intervention to prevent vision loss and blindness
2. Don’t rub your eyes: Every time you rub your eyes, you are damaging them little by little. Eye rubbing is one of the most common causes of blindness in young patients
3. Eye Protection: even if you don’t need glasses, it’s important to wear eye protection when you’re doing work that could damage your eyes (yes! Even trimming your lawn)
4. Contact Lens Hygiene: if you wear contact lenses, it’s important to work with a local eye doctor to ensure they aren’t damaging your eyes. It’s also important to not wear contacts in pools or hot-tubs and to avoid sleeping in them routinely.

Benefits of Cornea Surgery

In most cases, people who have undergone a cornea transplant see more clearly and, in some cases, have reduced eye discomfort. A cornea transplant is considered safe and takes an average of around two hours to perform.

Just like the eye, every surgical outcome is unique to the patient. Long-term success depends on several factors, including the underlying condition and overall eye health. If you’re experiencing any of the symptoms listed above, it might be time to schedule a consultation with your eye doctor.

A New Outlook

At Vance Thompson Vision, our comprehensive refractive and corneal surgery team has the expertise, tools, and facilities required to correct a variety of vision problems, and we are committed to finding the solution that’s right for you.

Want to know more about cornea surgery? Contact us at (605) 361-3937 to schedule an appointment for a complimentary consultation today.