Cornea Conditions & Surgery
Dr. Novick is a fellowship-trained cornea and refractive surgeon. He performs cornea surgery for a variety of corneal conditions. These surgeries include cornea transplants, astigmatic keratectomy, pterygium, and a variety of other surgical procedures for disease and visual rehabilitation for his patients.
What is your cornea?
Your cornea is a clear tissue that covers the front of each eye. Light entering your eye first passes through the cornea, then your pupil (the dark spot at the center of the colored iris), and then your lens.
The cornea must remain clear for you to see properly. However, a number of problems can damage the cornea, affecting your vision. These include:
- Corneal scarring from trauma and infection.
- A degenerative condition in which the cornea becomes thin and misshapen.
- Inherited corneal conditions (dystrophies) like Fuchs' dystrophy, Lattice dystrophy, and others.
The surgeon will remove all or part of your cornea and replace it with a healthy layer of tissue. The new cornea comes from people who have chosen to donate their tissues at the end of their life.
A cornea transplant, also called keratoplasty, can bring back vision, lessen pain, and improve the look of your damaged cornea.
Who Needs One?
The light rays that pass through a damaged cornea can get distorted and change your vision.A corneal transplant corrects several eye problems, including:
- Cornea scarring because of an injury or an infection
- Corneal ulcers or "sores" from an infection
- A medical condition that makes your cornea bulge out (keratoconus)
- Thinning, clouding, or swelling of the cornea
- Inherited eye diseases, such as Fuchs' dystrophy and others
- Problems caused by an earlier eye operation
Types of Cornea Transplants
Penetrating (full thickness) cornea transplant. This involves transplanting all the layers of the cornea from the donor.
Lamellar cornea transplant. During this procedure, the surgeon only replaces some of the layers of the cornea with the transplant.
In a lamellar cornea transplant, selected layers are transplanted, which can include the deepest layer, called the endothelium (posterior lamellar cornea transplant). A commonly performed version of this procedure is the Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK).
Or it can include layers closer to the surface (anterior lamellar cornea transplant).
Lamellar transplants may be more appropriate than full penetrating transplants when the disease process is limited to only a portion of the cornea.
The cornea of people who have astigmatism is shaped like a football. Astigmatic keratotomy eye surgery corrects astigmatism by making one or two incisions at the steepest part of the cornea. These incisions cause the cornea to relax and take a more rounded shape, thereby reducing astigmatism.
People with mild eyeglass or contact lens prescriptions generally have the most success in obtaining normal vision after astigmatic keratotomy eye surgery. People with more severe astigmatisms may still require glasses or contact lenses after astigmatic keratotomy eye surgery.
Astigmatic keratotomy eye surgery is a safe and effective way to correct astigmatism and it's often used in conjunction with other vision correction procedures.
Pterygium (pronounced tur-IJ-ee-um) is a common eye condition that affects people who spend a lot of time outdoors. People with pterygium have a growth of pink, fleshy tissue on the white of the eye. It usually forms on the side closest to the nose. Pterygium is also known as surfer's eye because it often affects surfers.
It is a noncancerous lesion that usually grows slowly throughout life. Or it may stop growing after a certain point. In rare cases a pterygium can continue growing until it covers the pupil of the eye and interferes with vision. A pterygium may affect one or both eyes. When it affects both eyes, it is called a bilateral pterygium.
Pterygium is usually not a serious condition. But it can cause annoying symptoms such as a feeling of a foreign body in the eye.
If the lesion causes persistent discomfort or interferes with vision, it can be surgically removed during an outpatient procedure.