New Cornea Transplant Surgery Reduces Recovery Time

Like a wrinkled up piece of paper, the cornea in Gertrude Rhodes’ left eye badly affected her vision. That’s until she underwent a new procedure recently.

A dome-shaped transparent covering of the eye, the cornea is lined with cells that keep it clear.

When the cells are damaged, the cornea swells, becomes cloudy, and impacts a person’s vision.

Descemet’s Stripping Automated Endothelial Keratoplasty, or DSAEK, is a new cornea transplant procedure, said Dr. Jennifer Murray, an ophthalmologist with the Eye Institute at the Medical Center Clinic in Pensacola. Dr. Murray, the first to offer the DSAEK procedure locally, said it’s an alternative to the commonly used penetrating keratoplasty, or full thickness cornea transplant.

In the past, physicians had to cut through all five layers of the patient’s cornea to reach the center of the patient’s cornea for repair. With DSAEK, however, only the problem layer of the damaged cornea is replaced, said Dr. Murray, who also is a specialist in corneal external disease and refractive surgery.

Doctors make a small incision from the side of a person’s eye and insert a thin piece of the donor corneal tissue. The new tissue then sticks to the back surface of the old cornea, which helps it to heal.

“The biggest thing of all is that (a patient’s) visual recovery time now is six to eight weeks versus 12 to 18 months, before,” Murray said.

And compared to the 16 stitches needed to suture the inner layers of the eye in the full thickness transplant, stitches are only done on the outside of the eye with DSAEK.

“What that does is, it allows their cornea to be much more stable and keeps the integrity of the tissue much stronger,” Dr. Murray said.

Some people may still require the previous procedure, despite these new advances, Murray said.

Murray used DSAEK on June 20 for the first time to repair Rhodes’ vision.

She performed the same surgery Tuesday on four more patients. Soon, Dr. Murray will have some company.

Pensacola ophthalmologist Dr. Saul Ullman plans to begin using the new transplant procedure this fall.

However, he said it’s important to note that DSAEK “can only be used in situations where the primary problem with the cornea is the inner layers of the cell” (called the endothelium).

Unfortunately, there are several instances where the DSAEK procedure cannot be used to fix the cornea problem.

For instance, he said, if you have a corneal scar from an injury or if your cornea is distorted, the procedure would not help.

Generally, about 50 percent of patients with corneal disease could be helped potentially by DSAEK he said.

“I believe DSAEK is an exciting new procedure and will offer select patients an excellent alternative to the old traditional full thickness corneal transplant,” Ullman said. “The advantages include faster visual rehabilitation and fewer visits to the doctor.”

Even though cornea transplant can be performed on anyone, Murray said, generally seniors ages 50 and older are more likely to have the procedure done.

Rhodes, 79, who also had the full thickness procedure about a year ago to repair her right eye, said there’s a marked difference between the two procedures.

“The last time, it took a couple of months to heal,” Rhodes said. “It’s been just a few weeks with this one.”

One year ago after the full thickness transplant, Rhodes said she also had to have follow-up visits every day for two weeks. Since her recent surgery, she’s been back to see Murray only once.

Some experts still advise doctors and patients to proceed with caution because the procedure is still in the infant stages, with little data to prove its success.

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