Corneal Disease Treatment from The Eye Clinic of Florida

Dr. Mahootchi serves on the medical advisory board of the Lion’s Institute for Transplant and Research. He was the first to perform corneal endothelial transplants in the Tampa Bay area.

Our cornea is the front window of the eye. LASIK changes its shape and the eye’s prescription; dry eyes can make it feel scratchy, and getting something in it sure can hurt. We deal with many cornea problems each day. Learn more about our specialty cornea care center here in Tampa Bay.

The cornea is the clear front surface of the eye. It covers the colored iris and dark pupil. It allows light to pass into the eye and helps to focus the light onto the retina (or the film of the eye). There are many corneal diseases that can affect the clarity and shape of the cornea, which can result in a partial or total loss of vision. When the cornea is cloudy, it is like looking through a dirty window.

Corneal Diseases

There are many reasons why the normal, clear cornea may become cloudy or not focus light correctly on the back of the eye. Viral infections, infections from overwearing contacts, and injuries some of the most common ophthalmic conditions.

Corneal Edema: This is the most common reason to need a cornea transplant. In a healthy eye, the back layer of cells on the cornea (called the endothelium) normally continuously pump water out to keep the cornea tightly packed and to allow light to pass through it undisturbed. With corneal edema (most commonly caused by Fuch’s Dystrophy, these cells do not regenerate and slowly die off during a person’s life. If a person loses too many of these cells, the cornea will swell and become cloudy. Corneal transplants are the most common type of human organ transplants.

Full-thickness corneal transplants are being replaced by endothelial transplants, which just replace the defective part of the cornea. Those transplants go by the names DSAEK, DMEK, and PDEK. The recovery is months faster than the older way of doing it. In fact, recovery in a week is not uncommon.

Tampa has the largest non-profit eye bank in the world so getting tissue is almost never an issue. Insurance, however, is almost always an issue! We can do a transplant, but you need a donor cornea. Think no kidney and the best surgery in the world can’t do a transplant. Some insurances in the Tampa area like to play games with paying for tissue and processing. We can help you navigate the process so you get the best results.

Keratoconus: The normal cornea has a shape like the front portion of a ball. However, some people in young adulthood develop a progressive thinning of the cornea that causes the cornea to develop an irregular shape. This is a slow, progressive disease called keratoconus. As the cornea’s shape becomes more irregular, light rays that enter it are scattered and not focused correctly onto the retina in the back of the eye. Initially, glasses or contact lenses may be able to correct the distortion, and some people with keratoconus may never need surgery. However, other patients’ corneas may become increasingly irregular or scarred to the point that even hard contact lenses will not allow them to see well.

There are cousins of keratoconus like margin pellucid dystrophy and others. These conditions are frequent causes of not being a LASIK candidate. New technology like corneal cross-linking and specialty contacts can help people avoid surgery and see well. Corneal transplants, usually full-thickness transplants, and sometimes a procedure called DALK and Bowman’s Membrane Transplants are surgeries to correct keratoconus. Let Dr. Mahootchi and our team guide you to the best choice for your eyes.

Corneal Scarring: Just like scar tissue can form on a person’s skin; it can also form on the cornea. It most commonly occurs after an infection or trauma. The most common infections that lead to scar tissue are bacterial infections (often after contact lens-related corneal ulcers) or virus infections (such as herpes or zoster viruses). Severe chemical burns may also cause extensive corneal scarring. The right kind of early treatment can make things a lot easier. Early medicine therapy can help avoid surgery. Transplants and other procedures are available for more severe cases.

Corneal Dystrophies: These are abnormalities of specific layers of the cornea that can result in corneal scarring or swelling. Some dystrophies are inherited, but others may develop from new mutations and may not be inherited. Some dystrophies may result in corneal problems in childhood, and others may not manifest until later in life. The most common dystrophy requiring a corneal transplant is Fuchs’ dystrophy, which typically results in corneal swelling that develops later in life.

Photo of Fuch’s Corneal Dystrophy

Failed Corneal Grafts: Some people who have had a cornea transplant in the past may reject the donor tissue, or the tissue may fail by itself after many years. These patients can usually undergo a repeat cornea transplant or sometimes just replace the endothelium as a more simple procedure.

Corneal Transplant FAQ

NOTE: Corneal Transplants and Lens Implants used during cataract surgery are often confused by the general public. Implants are used to replace the cloudy lens during cataract surgery. Corneal Transplants treat a different part of the eye, are less commonly used, and treat diseases and scars of the cornea.