Cornea and External Diseases

The cornea is the outermost clear tissue of the eye where light begins its journey into the eye. For most people, the cornea helps provide good vision throughout life, though some people may need spectacles, contact lenses, or refractive surgery in order to sharpen that vision. Like the windshield of an automobile, it is subject to considerable abuse from the outside world.

Variety of diseases can affect the cornea:

  • Fuchs’ dystrophy
  • Corneal edema
  • Corneal dystrophies and degenerations
  • Recurrent corneal erosions
  • Keratoconus and corneal ectatic diseases
  • Corneal trauma
  • Corneal infections/ulcers
  • Allergy eye and allergic conjunctivitis
  • Pterygium
  • Herpetic Eye Disease
  • Ocular surface tumors
  • Dry Eye and MGD
  • Neuropathic Corneal Pain
  • Ocular Surface burns

Cornea Transplant (Keratoplasty)

Physical injury to the cornea, certain infectious diseases, and degenerative conditions such as keratoconus can leave the cornea scarred and less than perfectly clear. In such cases, a cornea transplant becomes necessary in order to restore good vision.

Different Types of Corneal Transplant

Cornea transplantation is the most performed tissue transplant in the world.

PKP (Penetrating Keratoplasty): This is the traditional and still the most commonly performed corneal transplant where the entire diseased cornea is replaced with a donor human cornea.  It works best in cases where all the layers of the cornea are affected. Penetrating keratoplasty is highly successful and works very well to restore the vision when it is necessary.

DMEK (Descemet’s Membrane Endothelial Keratoplasty): This revolutionary technique replaces only the innermost layers of the cornea: the Descemet’s membrane and associated endothelial cells of the cornea. It is usually used in patients with Fuchs’ Dystrophy or other causes of endothelial failure. DMEK is so successful that it can restore a cornea back to its normal state with excellent vision.

DSEK (Descemet’s Stripping Endothelial Keratoplasty): DSEK is another type of endothelial keratoplasty in which the the innermost layers of  the cornea are replaced.  It is used in cases of endothelial failure when DMEK may not be possible.

DALK (Deep Anterior Lamellar Keratoplasty): DALK is another partial-thickness transplant procedure. In a DALK surgery, the endothelial layer is left intact, and only the outer layers of the cornea are replaced with donor tissue. This technique is most commonly used in cases of advanced keratoconus or other disease processes that affect the stroma but leave the endothelium unaffected.

Pediatric Corneal Transplants

Believe it or not, kids as young as newborns may require cornea transplant due to certain congenital conditions and hence face the risk of living with blindness for their life. Pediatric keratoplasty poses unique challenges in both clinical and surgical management. Pediatric cornea transplants are difficult to perform and have a high risk of rejection. Nevertheless, the benefit of early vision stimulus that a newborn can achieve has been found to play a profound role in the child’s overall development. Long-term graft survival can be obtained with care across ophthalmic specialties, and a commitment to long-term follow-up by the patient’s family. Few surgeons are willing to take on this challenging procedure because of the complex nature of the surgery and the low success rate. Dr. Goyal, with her compassion and expertise has helped such families.

You’ve got questions? We’ve got answers..

Does insurance cover cornea transplant? Corneal transplants are often covered by medical insurance. We will work directly with your insurance company to determine your benefits and whether you will have any out-of-pocket costs.

When can I return to work after a corneal transplant? Most patients are able to return to work within a few days of corneal transplantation. The vision is usually still blurry after surgery so only one eye is done at a time. It is OK to resume regular activities 1 to 2 weeks after surgery. You may need to avoid vigorous activities for longer depending on your surgery and speed of recovery.

Do you perform pediatric K transplants? Yes, Dr. Goyal will work with the kid’s pediatric ophthalmology team to provide a comprehensive management plan.

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Phone: 407-243-8715, Phone: 407-261-4411
FAX: 407-326-6960

10962 Moss Park Road, Suite 200
Orlando, FL 32832

Mon-Fri: 8:00am-5:00pm
Saturday: 8:00am-2:00pm (Appointment Only)
Sunday: Closed