Leading-Edge Eye Doctor in Zephyrhills, FL

Corneal Disease Eye Surgery for Vision Repair

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’s like looking through a dirty window.

Here are some of the most common types of corneal disease we see:

• 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 pumps 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.
• 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 Surgery: What to Expect

• Before surgery: Once you decide to proceed with the surgery, we call the Eye Bank and look for the best tissue available. We usually don’t have a waitlist. We have never had to delay surgery because of donor issues. Before a cornea is released for transplantation, it is inspected for clarity, and the eye bank tests the tissue for different viruses, such as hepatitis and HIV. If you are taking any blood thinners (such as coumadin, Plavix, or aspirin), you may need to stop these medications for a few days before the surgery if it is OK with your primary care doctor. You will be asked not to eat or drink anything for 8 hours before your surgery.
• The day of surgery: The surgery is done on an outpatient basis, which means you will be able to go home on the same afternoon of the surgery. Once you arrive at our Same Day Surgery Center, you will be given some eye drops and a sedative to help you relax. You will also be given some medicine to numb up the eye so that you will not feel any pain.
• The operation: Your eyelids will be gently kept open with a lid speculum, so you don’t worry about blinking or keeping your eyes open. The center of the diseased cornea is carefully removed, and any additional work (such as removal of a cataract) is completed. Then the clear, donor cornea is sewn into place. A microscope is used to perform the surgery and the operation takes about 1-2 hours. Drawing that shows steps of a full-thickness corneal transplant. After the diseased cornea is removed-the donor cornea is put into place.
• After the operation: A patch and shield will be placed over your eye and you will be allowed to go home after a short stay in the recovery unit. For some, we will ask you to stay on your back as much as you can for the next 2 days

You will need someone to drive you home after the surgery, but once you get home, you will be allowed to eat and perform most activities. You will be able to watch TV and read from your other eye as your operated eye recovers from the surgery. You will come in for a follow-up appointment the day after the surgery. We will ask you to be careful not to rub or get anything in your eye and to use your eye drops as prescribed.

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.

We provide two types of surgeries:

• DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty): DSAEK removes and replaces the back layer of the cornea with healthy donor tissue.

• DMEK (Descemet’s Membrane Endothelial Keratoplasty): DMEK corneal surgery is a newer, thinner transplant option for precise healing, with even fewer sutures and a faster recovery time compared to DSAEK.

Trust The Eye Clinic of Florida to guide you through every step of your corneal disease treatment, from consultation to post-surgery recovery. With advanced solutions and compassionate care, we’re here to help you see clearly again.