The cornea is the clear part in front of your eye, or the window of the eye. The cornea must remain clear in order to provide good vision, because light passes through it and onto the retina where is is focused. Many things can cause a cornea to become cloudy. Any type of scarring from an injury, degeneration, or Corneal disease can all contribute to a cloudy cornea, resulting in decreased vision.
Replacing the old with the new
Donor tissue comes from individuals who have donated their cornea and is necessary when replacing a cloudy cornea. The donor is carefully screened for diseases and infections which include hepatitis, syphilis, and also AIDS. The corneas that we use comes from an eye bank that is carefully regulated by the FDA.
Descemet membrane endothelial keratoplasty or DMEK is the most exciting option available to us when treating decreased vision and swollen, cloudy corneas. DMIK has also been shown to offer patients the best chance at obtaining 20/25 vision or better and resume to normal daily activities without worrying about a vision-threatening rejection. A thin membrane of only about 15 to 20 microns thick is used to safely replace the cloudy area.
Anterior Lamellar Corneal Transplant
Sometimes scarring can cause a cloudy front half of the cornea. With this procedure, the cornea is dissected in half and the front of it is removed. The new donor cornea can then be sewn into place. This method decreases invasive surgery and your eye will be much stronger than it would have been with a full width transplant.
Posterior Lamellar Corneal Transplant
DLEK is performed when the inner cell layer of the cornea has stopped working. By dissecting the cornea into 2 layers through a small incision on the side of your eye, the back portion of the cornea can be replaced. The natural suction of the cornea will hold the new layer in place, as well as a few small stitches.
There is usually less astigmatism when using the DLEK procedure and the eye remains stronger than with a full thickness transplant.