Dr. Paul Ernest appeared on the Bart Hawley Show last week to discuss the new lens for cataract surgery that is changing the game.

Dr. Paul Ernest on The Bart Hawley Show from JTV Studios on Vimeo.

Who Is Corneal Transplant Surgery For?

Over 40,000 people undergo a cornea transplant in the United States each year. Corneal transplant surgery is recommended for people who have:

• Vision problems are caused by thinning of the cornea, most often due to keratoconus. A cornea transplant may be considered when less invasive treatments are not an option.
• Scarring of the cornea from severe infections or injuries
• Vision loss is caused by cloudiness of the cornea, most often due to Fuchs’ dystrophy

During these procedures, damaged tissue on the eye’s clear surface – the cornea – is replaced.

Replacing The Cornea

As the front, clear layer of the eye, corneas are a unique part of the body and feature five layers (from front to back); Corneal epithelium, Bowman’s layer, Corneal stroma, Descemet’s membrane, and Corneal endothelium. Problems with any of these layers can cause blurred vision, glare, and distortion.

Up until 2006, when the cornea became cloudy, transplant procedures required the removal of all five layers of the cornea and replaced it entirely. This required a lengthy and uncertain visual recovery period. In 2006, Dr. Kevin Lavery was the first in Michigan to perform Descemet Stripping Automated Endothelial Keratoplasty (DSAEK).

This was a vast improvement as the top two layers of the cornea were undisturbed. Now we have Descemet Membrane Endothelial Keratoplasty (DMEK). DMEK is not only changing the way cornea transplants are performed, but also improving the results. With this procedure, only the innermost layers are replaced. Removing fewer layers means a more pure replacement.

The DMEK procedure targets patients whose inner endothelial cell layer is diminished and the stroma is becoming waterlogged. The cornea’s transparency is dependent on its inner cells’ ability to pump fluids – and when it fails, it swells and results in cloudy eyes.

Before DMEK, Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) was the most common transplant procedure.

Three Advantages of DMEK over DSAEK Corneal Transplant Surgery

Improved Vision

Greater portions of DMEK patients are attaining 20/20 vision or better following the procedure compared to DSAEK.

Improved Visual Recovery

While a patient’s vision is a bit fuzzy following the procedure, as the days progress it improves. For DMEK, the visual recovery path is much faster, taking only weeks instead of months. Patients are able to resume normal activities more quickly as well, as most are back to their regular activities within a week.

Reduced Risk of Rejection

When replacing the entire cornea, there is a risk of rejection. In procedures where all five layers are removed, rejection occurs in about 20% of the transplants. With DMEK, that risk is reduced to 1-2%.

The DMEK procedure takes about 30 to 40 minutes, a slightly longer procedure than DSAEK. However, the process is still being mastered, so it’ll likely soon become a shorter procedure. During the procedure, the patient is administered anesthesia and the diseased innermost layer of the cornea is carefully removed. Then, the healthy donor cornea is inserted and held in place by an air bubble, which goes away within the first week.

Specialty Eye Institute is proud to offer this procedure. It’s a procedure that requires a commitment from our entire team – from the staff to the eye doctors. Many eye surgeons in the state still aren’t performing this technique because of the steep learning curve and required training. Contact SEI today to learn more about corneal transplant surgery!

It’s estimated that 60 percent of Americans will develop a cataract in their lifetime. As the most common cause of vision loss, untreated cataracts potentially could lead to blindness.

There are varying treatment options for cataracts and revolutionary technology is making cataract surgery more precise and effective than ever. That technology is the femtosecond laser.

What is femtosecond laser technology?

Femtosecond laser technology has improved the safety and accuracy of cataract surgery. At Specialty Eye Institute, we specialize in treating cataracts and performing laser cataract surgery.

What’s the difference between traditional and laser cataract surgery?

In traditional cataract surgery, the surgeon uses a handheld instrument to make incisions in the cornea. After the incisions have been made, the surgeon will manually create an opening in the lens capsule where the cataract is located.

During laser cataract surgery, the femtosecond laser replaces or assists the hand-held surgical tool, and the laser creates a circular opening for accessing and removing the cataract. Clinical studies have said cataract surgery can be 10 times more accurate when using a laser.