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Irondequoit Office
Eye Surgery |
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Corneal Transplant / DSAEK
Corneal transplantation, or keratoplasty, replaces the damaged cornea with a healthy one from a donor. It is a low-risk procedure and is the most common type of transplant surgery that has the highest success rate.
During a corneal transplant, a circular incision is made in the cornea. A disc of tissue is removed and replaced with healthy tissue. Local and/or general anesthesia may be used. The entire procedure lasts between 30-90 minutes.
Corneal transplantation is an alternative treatment to INTACS prescription inserts and rigid gas-permeable contact lenses for patients with keratoconus.
DSAEK
DSAEK is the latest technique in corneal transplantation. Short for Descemet-Stripping Automated Endothelial Keratoplasty, DSAEK offers clear post-operative vision and short recovery time to patients in need of new corneas.
During the procedure, the surgeon makes a mark in the surface of the patient's cornea with a trephine (an instrument used to cut circular sections of tissue). That mark serves two purposes: it helps the surgeon determine what size the transplant should be, as well as outlining the area of the patient's cornea that needs to be peeled away. Next, the surgeon scores the damaged section of the cornea and strips the membrane away from the eye. The donor cornea is folded into a "taco" shape and placed on the eye. Only a single stitch is needed to close this incision.
Sometimes the new cornea unfolds on its own; other times, the surgeon unfolds it him/herself. When it is unfolded, a second stitch is made to close the wound and anchor the new cornea in place. The surgeon then injects an air bubble underneath the cornea, making sure it is centered on the eye.
Patients are sent to the recovery room for about one hour, after which they are examined at the slit lamp with the doctor. He or she gently presses on the cornea until most of the air bubble is released. Patients are then given antibiotics and steroid eye drops and asked to return the next day for a follow-up appointment.
Glaucoma Treatment/Surgery
Glaucoma is an eye disease in which pressure inside the eye (intraocular pressure) rises to a dangerous level, damaging the optic nerve and causing vision loss. In a healthy eye, fluid is produced in the ciliary body, enters the eye, and then drains through tiny passages called the trabecular meshwork. In people with glaucoma, these passages become blocked and intraocular pressure rises.
Glaucoma is a leading cause of blindness in the U.S. The condition often develops over many years without causing pain or other noticeable symptoms - so you may not experience vision loss until the disease has progressed.
Symptoms that you could be developing glaucoma include blurred vision, loss of peripheral vision, halo effects around lights, and painful or reddened eyes. People at high risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.
To detect glaucoma, your physician will test your visual acuity and visual field as well as the pressure in your eye. Regular eye exams help to monitor the changes in your eyesight and to determine whether you may develop glaucoma.
Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include non-surgical methods such as prescription eye drops and medications, laser therapy, and surgery.
Glaucoma vision
Common surgeries include:
- Laser Peripheral Iridotomy (LPI) - For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
- Argon Laser Trabeculoplasty (ALT) For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients.
- Selective Laser Trabeculoplasty (SLT) is an elective procedure and is used to lower the eye pressure. In SLT, a laser treatment is applied to the drain of your eye in order to open it up and let fluid out. By using laser light, it stimulates the body's own healing response to lower the eye pressure. Using a special wavelength and energy, the laser affects only pigmented (melanin containing) cells of your eye. SLT improves the flow of fluid in the eye, which in turn lowers the eye pressure, and helps preserve the eyesight. The SLT treatment only takes a few minutes and is performed in an office setting.
- Nd:YAG Laser Cyclophotocoagulation (YAG CP) - For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
Filtering Microsurgery (Trabeculectomy) - For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).- Tube Shunt Surgery - May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.
Go to National Eye Institute to Learn more about glaucoma
http://www.nei.nih.gov/health/glaucoma/glaucoma_facts.asp
