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Corneal Transplants & Surgery at Alabama Eye & Cataract Center at UAB Highlands in Birmingham, AL

By Marc Michelson, M.D.

About Corneal Surgery & Transplants
As Corneal Specialist, Marc Michelson, M.D. performs corneal transplants. Most often he can treat the range of cornea problems and conditions and corneal diseases using non-surgical treatment options. However if they are not diagnosed and treated early or if they progress to where vision is compromised beyond an acceptable level, it may be necessary for him to perform a corneal transplant.

What Is A Corneal Transplant?
A corneal transplant is a type of eye surgery Dr. Michelson performs in order to replace diseased, damaged or scarred corneal tissue with new healthy corneal tissue. Since damaged or scarred corneal tissue does not allow light to effectively pass into the eye and reach the retina, poor vision and even blindness may result from a damaged cornea. There are actually a number of different types of corneal transplants that can be performed, including:

Penetrating Keratoplasty: This type of corneal transplant involves the surgical removal of the central two-thirds thickness of the damaged cornea. Your cornea surgeon first removes the central portion of the damaged or cloudy cornea with a “cookie cutter” like instrument called a trephine, and replaces it with a clear cornea obtained from the eye bank. He then very carefully sews the donor cornea into place using sutures that are thinner than a human hair. To facilitate the healing of the new transplanted cornea, your cornea surgeon prescribes eye drops for patients who have had corneal transplants. After we have determined that the new cornea has healed properly, we will remove the fine sutures or stitches he put in place during the surgery. Usually he will remove these sutures right in our office at Alabama Eye & Cataract Center. This is the most common type of corneal transplant. This type of transplant has the potential to provide the clearest vision after healing because there is no interface (layer) to look through. However, the healing time is longer and the use of a contact lens might be required for the clearest vision.

Lamellar Keratoplasty: Your cornea surgeon may perform this type of corneal transplant if the damaged corneal tissue is mainly located in the outermost 50% of the cornea. Essentially, we will carefully dissect the outermost half of the cornea and remove it along with the damaged tissue. Then a new donor cornea is sewn into place. This type of corneal transplant is less invasive and will allow your eye to be stronger after surgery than it would be with a regular full thickness transplant, or Penetrating Keratoplasty. However, in some cases there can be some loss of clarity from the interface between the new and remaining layers of the cornea.

Decemet’s Stripping with Endothelial Keratoplasty (DSEK): This type of corneal transplant is performed through a small incision, to remove and replace the inner cell layer of the cornea when it stops working properly. With this technique, Dr. Michelson gently “strips” off the single diseased cell layer, called the Endothelium, and leaves the remaining cornea intact. Dr. Michelson will then thinly slice a donor cornea from the eye bank and fold the back portion in half and inserts it through a small incision into the eye. He will then use an air bubble to unfold and position the donor tissue on the recipient cornea. Within a few minutes the donor tissue attaches to the recipient without the use of any sutures. There are a number of advantages of DSEK if you are indeed a candidate:

  • Your eye remains much stronger
  • Visual recovery is very rapid
  • DSEK causes little change in eyeglass glasses prescription

Corneal Transplants have become somewhat common in the United States as a treatment for damaged and cloudy corneas. Each year more than 40,000 people undergo corneal transplantation to restore their vision. If we find that other methods of treating your corneal disease or corneal condition are inadequate to give you good sight, he will fully discuss the risks and benefits of corneal transplantation and take the time necessary to answer all of your questions.

If you or someone you know would like to learn more about corneal transplants and surgery or needs an appointment, please call Alabama Eye & Cataract Center at 205-930-0930 to schedule an appointment.