Advances in Corneal Transplantation

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New techniques for corneal transplantation are associated with improved safety and more rapid visual recovery along with equal or, in some cases, better visual results, says Anthony Aldave, MD, director of the Cornea Service at UCLAs Jules Stein Eye Institute. Corneal transplantation, which replaces a patients damaged cornea with donor corneal tissue, is the most common and most successful type of human transplant surgery; approximately 40000 procedures are performed in the United States each year. The cornea — the clear tissue that forms the front of the eye — can become diseased, affecting vision and requiring transplantation as a result of a variety of conditions, including progressive distortion in the shape of the cornea (keratoconus), scarring secondary to infection or injury, and inherited dysfunction of the corneas inner layer, leading to corneal swelling (Fuchs dystrophy). Until recently, the procedure of choice for most of these patients was what is called a full-thickness corneal transplant, also known as a penetrating keratoplasty, in which the full thickness of the cornea is replaced, even if only a portion of the cornea is diseased. But several new procedures have emerged that are designed to remove and replace only the affected layer of the cornea. For patients whose vision is affected by swelling in the corneas inner-most layer, the Descemet stripping endothelial keratoplasty (DSEK) — which involves peeling off the diseased inner layer and replacing it ...

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