Transplants - Keratoplasty
Keratoplasty is the transplant
of a donor cornea to replace part of or your entire cornea. Keratoplasty
is performed to treat a variety of conditions including:
Keratoconus - where your cornea bulges outward
Swelling or scarring of the cornea - can happen
by injury to the eye or infection
Thinning of the cornea
Complications caused by previous eye
After the procedure, you should experience relief from
pain or discomfort that is associated with these conditions. As with any
transplant, there are risks, such as a rejection of the donor cornea.
However, most Keratoplasty procedures are successful, particularly in
the hands of an experienced skilled surgeon like Dr. McMann.
If you think you are experiencing symptoms of donor
(sensitivity to light, loss of vision, pain, or redness in the
make an appointment with us right away.
The following steps must be taken prior
to the procedure:
1. Eye Exam
Dr. McMann will
perform a thorough eye examination to look for any existing conditions
that might cause complications after the procedure. If you have any
other unrelated eye problems, these will be treated prior to surgery.
2. Eye Measurements
We will need
a proper measurement of your eye so Dr. McMann can determine what size
cornea will be needed for the replacement.
Keratoplasty is virtually painless and your eye will be
numbed during the procedure. Dr. McMann will cut through the cornea and
remove the tissue (about the size of a button). Then the donor cornea
(already sized to fit) is stitched into place. In a partial cornea
replacement, Dr. McMann will remove only those layers that need
removing. For the inside layers, a very small incision will be made to
allow for the removal and replacement without disturbing the outside of
your eye. For the outside layers, they will simply be removed and
After the Procedure
You will receive eye
drops and an oral medication to prevent infection. You will be required
to wear a protective eye covering consisting of gauze to reduce swelling
and metal to prevent injury or trauma to the eye. Follow-up exams are
necessary after Keratoplasty and the frequency of these exams will
depend upon your specific procedure and healing process.
Descemet's Stripping Endothelial Keratoplasty (DSEK)
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.
corneal transplants are performed each year in the United States, often
for patients with corneal swelling or edema. 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
Not all patients who require corneal
transplants are candidates for DSEK. This procedure is best suited for
those who have corneal edema or swelling. Please call us to schedule an
appointment to determine if DSEK is for you.
The cornea is the outer layer of your eye and it should be
transparent to allow the focus of incoming light. Corneal dystrophy is
traditionally a hereditary disease that happens when abnormal material
grows or accumulates within one or more layers of the cornea of both
eyes. There are multiple types of corneal dystrophy, classified by which
layer of the cornea the disease affects and the specific infection or
Some corneal dystrophies can create vision impairment
while others may have no symptoms at all. Corneal erosion is a common
symptom found with multiple forms of corneal dystrophy. This symptom
causes discomfort or even extreme pain as the epithelium layer of the
cornea separates from the eye.
Corneal dystrophies can be found
during routine eye exams and some can be diagnosed with molecular
genetic tests, often before symptoms begin to surface. Treatments will
vary depending on the specific type of corneal dystrophy, ranging from
observation to eye drops, ointments, antibiotics, special contact
lenses, or even excimer laser treatment.
Genetic counseling may
be of benefit for affected individuals and their families. Other
treatment is symptomatic and supportive. If you have corneal dystrophy
in your genetics, regular exams are the best preventative treatment. If
you think you might be experiencing corneal dystrophy, please call us to
make an appointment.