Corneal Surgery Update

By Andrew Feinberg M.D.

We continue to expand here at Georgia Eye Partners, as our cornea department opens the doors to a brand new suite at our north location this September, and welcomes the vast experience of Dr. Karen Sumers to the practice! What better opportunity exists to discuss some exciting trends in corneal surgery in recent years. While we work hard every day to achieve a medical cure for our patients with corneal disease, certain patients of course progress to the point where they require surgical intervention.

Full thickness corneal transplantation or penetrating keratoplasty (PKP) has been a mainstay of cornea surgery for the last half century, and remains a popular option for many patients. Visual rehabilitation of these patients has been improved by recent techniques such as laser refractive surgery (PRK) after PKP, but for certain cases this rehabilitation remains challenging, as does the prospect of infrequent but significant complications such as wound leaks or graft rejection.

Thus the advent of lamellar surgical techniques, which selectively replace only the diseased layer of the patient’s cornea, have been a welcome advancement in cornea surgery in recent years. The DSAEK procedure, as the most popular example, has revolutionized surgical treatment for patients with Fuchs dystrophy and other pathological processes of the posterior cornea. Speed of visual recovery, drastic reduction in postoperative astigmatism, and reduction in the frequency of graft rejection and wound-related complications have all been major benefits of this procedure.

Patients with posterior corneal disease and cataracts have also enjoyed the advances offered by this procedure. Depending on the relative severity of the corneal disease versus the cataract, these patients can be offered DSAEK before, after, or most excitingly, in a single procedure combined with cataract surgery. While some special considerations are made for IOL spherical power selection in this setting, in general, astigmatism concerns are greatly reduced. Again, these patients do very well postoperatively, and enjoy a faster physical and visual recovery when compared to previously available options. If you have a specific patient to discuss regarding selection, timing, or combination of procedures or any other question, we encourage you to contact one of our surgeons today. We would love to speak with you!

Posted in: News and Updates

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