FAQ on Corneal Transplants

Dr. Edmonds in a lab coatIn July of 2013, Milwaukee Eye Care was fortunate enough to welcome Cornea Specialist, Dr. Jason Edmonds. In his short time with Milwaukee Eye Care, his practice has become very busy – he is regularly performing full and partial corneal transplants as well as cataract surgery. Here’s a little Q&A with Dr. Edmonds!

What is a Corneal Transplant? DSAEK?

The cornea is the clear window in the front of the eye through which light passes. In a corneal transplant, all or part of the cornea is replaced with corneal tissue from a donor. A full thickness transplant, also known as penetrating keratoplasty, is performed to restore vision in the case of severe disease or injury that scars or clouds all or most of the central cornea. There are other corneal transplant procedures that are performed to replace only a specific layer of the cornea. These procedures often have long and complex names that describe the layer of the cornea being replaced. We in the business often use abreviations for these transplants such as DALK, DSEK, DSAEK, DMEK, and others.

DSAEK stands for decemets stripping automated endothelial keratoplasty. In this procedure a cornea specialist replaces only the back layer of cornea with a thin partial thickness transplant from a donor. This procedure is primarily used to treat patients with a disorder called Fuch’s corneal dystrophy. In this disorder a single layer of the cornea, called the “endothelium” does not function as it would in a healthy individual. As a result the cornea can swell and become cloudy, leading to decreased vision.

Who is a candidate for surgery?

If surgery is being considered, a person with corneal disease or injury should be evaluated by an ophthalmologist who specializes in medical and surgical treatment of corneal conditions. The need for a corneal transplant is determined by the degree to which a patients vision is affected and the extent to which their activites of daily living are impacted. It is important to discuss with the surgeon the benefits and risks of a cornea transplant. Not everyone is a good candidate for surgery.

What kind of recovery can patients expect

I tell patients who undergo a full transplant that the recovery time can be anywhere from 6-12 months and that further surgery may be required to achieve their best possible vision. Partial thickness transplants offer a quicker recovery. DSAEK patients often achieve good visual outcomes as soon as 3 months after surgery.

What visual outcome can be expected?

This depends on the condition and the surgery performed. It also depends on the overall health of the eye and whether other conditions exist which may affect vision. It is important to discuss with your surgeon what the resonable expectations of visual outcome will be. Most patients will still require glasses or contact lens to achieve their best vision.

How long of a procedure is it?

Surgery times vary based on the complexity of the surgery. A partial thickness transplant may be completed in 30-45 minutes while a full thickness transplant can take close to 2 hours. The only way to know is to be evaluated by a cornea transplant specialist.

Will I be “knocked out” for surgery?

Most eye surgeries are not performed under general anesthesia where a patient is “knocked out.” Most are performed under partial sedation or “twilight” anesthesia. Patients are able to hear surgical staff and communicate with them but they are kept comfortable and sleepy. Many do not even remember surgery when they get home. Occasionally patients who undergo full corneal transplantation do require general anesthesia. They are put completely to sleep or “knocked out.” The type of anesthesia is determined by the surgeon and the patient prior to surgery.

If you have a corneal disease and are wondering whether you might be a candidate for surgery, make an appointment with Dr. Edmonds at Milwaukee Eye Care, where you are always in good hands.

Written by Paula W., Milwaukee Eye Care’ Technician and Surgical Coordinator for Dr. Edmonds