Cornea Surgery

CXL, DSEK, SK, PTK

Types of Cornea Surgery

CXL (Corneal Cross Linking)

ClearView is proud to be the first and only place in Central/Western PA to offer CXL. Pennsylvania to offer CXL.

This procedure is used to treat Corneal Ectasia, which can occur due to innate disease like Keratoconus, or as a complication of LASIK or PRK surgery.

Corneal Ectasia results from a cornea being too weak, too thin or both.

In Keratoconus, the cornea becomes weak, progressively thinner and irregular in shape, leading to severe astigmatism and blurred vision.  It is thought to be due to genetic and environmental factors (like severe eye rubbing, for example).  When mild, a pair of glasses or contact lenses can help patients see better.  When severe, a full thickness cornea transplant (PK–Penetrating Keratoplasty) has been the treatment of choice.

In ectasia after LASIK or PRK, the cornea has likely become too thin and too weak after LASIK or PRK surgery leading to severe astigmatism and blurred vision.  This is a rare, but potentially severe problem.

Just recently, the United States Food & Drug Administration approved Corneal Cross Linking, a procedure that can help in these types of conditions.

All corneas have cross-links between the collagen fibers that help keep the cornea strong and retain its normal shape.  The cross-linking procedure adds additional cross-links, making it more stable and strong, decreasing the astigmatism and helping the patient see better.

Research has shown that CXL can help prevent further vision loss in 95% of patients and actually improves vision in over 60% of patients.  The beneficial effects last for many years and there is some evidence that the strengthening may be permanent.  Typically, only 1 treatment is needed, though the procedure can be repeated if necessary.

Most importantly, it can help prevent the need for PK, the full-thickness cornea transplant surgery.

The procedure has been performed since 1999, and by 2006 all the European nations had approved it.  In 2016, the US FDA approved the procedure after years of study.

 


DSEK (Descemet Stripping Endothelial Keratoplasty)

DSEK is a partial thickness cornea transplant, replacing the failed inner lining (endothelial layer) of the cornea. This small incision technique selectively transplant the inner lining of the cornea, restoring sight to the patient.

DSEK involves replacing some of the defective inner layers of the cornea with healthy donated tissue. Both have a relatively small incision size when compared to traditional, full thickness, cornea transplants and offer a much lower risk of astigmatism.

DSEK provides the potential of rapid visual recovery while still maintaining the structural integrity of the patient’s eye. Frequently, two or fewer sutures are used during the entire procedure. The long-term risk to the eye with regard to rejection or injury/trauma is also much lower with this procedure than with traditional, full thickness, cornea transplants.

SK (Superficial Keratectomy)
This procedure is used to treat some of the most common Ocular Surface Diseases, including Recurrent Corneal Erosion (RCE) and Epithelial Basement Membrane Dystrophy (EBMD)

It is an in-office procedure that removes defective surface cells from the cornea so that healthy replacement cells can heal in naturally from the periphery of the cornea.

PTK (Photo-Therapeutic Keratectomy)
PTK goes one step beyond SK and is Dr. Parekh’s preferred treatment for corneal diseases such as RCE and EBMD . Once the defective surface cells are removed, an excimer laser is used to treat the underlying layer, so that the new, healthy replacement cells can take their place.

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