Corneal Transplant Surgery at The McMann Eye Institute

Dr. McMann is one of the few fellowship trained corneal surgery specialists in Hawaii.  Before moving to Hawaii in 2006, Dr. McMann had an additional year of special corneal fellowship training in corneal & refractive surgery at world renowned Emory University in Atlanta, Georgia.

Over 100 corneal transplants are performed each year in Hawaii.  The cornea is the clear, outer window of the eye and this is the most commonly transplanted tissue.  Whole eyes are not transplanted.

Why Do People Need Corneal Transplants?

The most common reason for a corneal transplant is long-term complications from cataract surgery.  The cornea becomes cloudy and swollen and can become very painful.  The transplant cures these symptoms and gives the recipient great relief.  Corneal transplants are also done to correct injured or scarred corneas.

Some people also develop a misshapen cornea in a disease called keratoconus.  In some cases of keratoconus,  the cornea needs to be replaced so that they can see.  There are a number of different eye diseases that are cured by a cornea transplant.  People of all ages need cornea transplants.  Although many recipients are elderly, they can be of all age ranges including newborns.

Descemet’s Stripping Endothelial Keratoplasty (DSEK)  

The old adage of, “If it’s not broke, don’t fix it,” has seen new application in the treatment of diseases of the cornea.  Dr. McMann is a member of a very small group of surgeons worldwide performing a new form of a corneal transplant procedure called “DSEK,” which stands for descemet’s stripping endothelial keratoplasty.  Dr. McMann was the first surgeon to ever perform a DSEK at Tripler Army Medical Center.   

About fifty thousand corneal transplants are performed in the United States yearly, often for patients with corneal swelling or edema.  In traditional corneal transplant surgery, the entire central cornea is removed and replaced with a cornea from a donor, much as it has been done for about 50 years.  In DSEK, only the thin damaged back layer or endothelium is replaced, leaving most of the patient’s cornea in place.  The expected results include faster return of vision, reduced risks of some complications, and a faster return to daily activities.

This selective type of DSEK surgery might be better understood with an analogy to car repair.  If your car breaks down because of a bad timing belt, it clearly would be better to replace the timing belt  than to replace your entire engine.  DSEK surgery is more like replacing the bad timing belt and conventional corneal transplant surgery is more like replacing the entire engine.

Not all patients who require corneal transplants are candidates for DSEK.  This procedure is best suited for those who have corneal edema or swelling.  For more information, please call our office at (808) 677-2733 (2SEE) and we would be happy to assist you.