Corneal Transplant Surgery: What You Should Know

hargrave eye centerYou may need a cornea transplant if your cornea no longer lets light enter your eye properly because of scarring or disease.  The first cornea transplant was performed in 1905 by Eduard Zirm (Olomouc Eye Clinic, now Czech Republic), making it one of the first types of transplant surgery successfully performed.  

According to the Mayo Clinic, a cornea transplant, also called keratoplasty, is a surgical procedure to replace part of your cornea with corneal tissue from a donor. Your cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of your eye’s focusing power.  A cornea transplant can restore vision, reduce pain and improve the appearance of a damaged or diseased cornea.  Most cornea transplant procedures are successful. But cornea transplant carries a small risk of complications, such as rejection of the donor cornea.

Types of cornea transplants include:

  • 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.

ocular healthExperts know more about the long-term success rates of penetrating cornea transplants, which use all the layers of the cornea.  Success rates are also affected by the problem that needed to be fixed with the transplant. For example, research from WebMD has found that the new cornea lasts for at least 10 years in:

  • 89% of people with keratoconus
  • 73% of people with Fuchs’ dystrophy
  • 60% to 70% of people with corneal scarring

The cornea tends to heal slowly. To help protect your eye in the days after the surgery, your doctor may ask you to wear a protective shield over it.  You will need to use eyedrops for several months after the transplant which can then be reduced to one drop a day or discontinued. The stitches may remain in your eye for months or years. Your eye doctor can remove them in a simple procedure during an office visit.  Your vision may improve slowly after the surgery. It’s important to avoid any possible trauma to your eye, such as from sports. This can damage your new cornea. You should report new irritation or any decrease in vision to your corneal surgeon. These may be signs that your body is rejecting the donor cornea. Most transplant rejections are fully reversible with steroid eyedrops if detected early enough.  Rejection may even occur years after the surgery. If you notice any of these signs that last for more than six hours, call your eye doctor promptly. The doctor can give you medicine that can help prevent as well as treat rejection.

Eye donors are screened to eliminate those with diseases that may be transferred to you via the donor cornea. The donor’s general and eye medical history are reviewed, and blood tests are performed for hepatitis and AIDS. AIDS has never been transmitted via corneal transplant, but it is tested as a precaution. While none of these tests are infallible, there is only a remote chance of transmitting disease via corneal transplantation.

 

Ocular Health & Lasik Surgery: A Surprise Success

LASIK surgeryResearch has shown that inflammation is one of the primary underlying causes for dry eye. Currently, there is only one FDA-approved pharmaceutical for treating the inflammation found in people with dry eye. However, many patients with moderate to severe symptoms often find that these treatments are just not enough.  Some experts have estimated that as many as 8 out of 10 LASIK patients deal with some dry eye symptoms in the weeks following their procedures.  But, that is not to say that LASIK surgery doesn’t have its benefits.

LASIK surgery is an experiential offering, especially amongst a burgeoning customer market.  Millennials (defined by the Pew Research Center as being between the ages of 18 to 34 in 2015) are projected to number 75.3 million, surpassing the projected 74.9 million Boomers (ages 51 to 69).  Laser vision correction is transformative.  This means a patient can enter your office one day with a visual acuity of 20/400 and return the following day 20/15. Millennials’ young age suggests an enduring lifespan to look forward to.  As specialists in refractive and implant vision correction, eye care specialists are taking advantage of this opportunity to help them see and, ultimately, experience life as it happens.

Additionally, millennials are not the only group that LASIK surgery has attracted in recent years.  In July 2015, the New York Times shared an article recounting the exceptional story of “Banner”, a five year old female Falcon that underwent a second round of laser eye surgery which helped her to fly again.  The falcon previously had cataracts.

Ocular Health

“Banner”, the five year old female Falcon stares at the camera lens which she is now able to see after three separate eye surgeries. Her handler, Nancy Cowan is in the background.
 
 
(Image Source: Alan MacRae/for the Monitor)
 

The doctor who performed the surgery, Dr. Andre A. D’Hemecourt said he needed to get approval before actually operating on a nonhuman patient.

Nevertheless, recent integration of state-of-the-art medical technology can be credited for an increased demand in eye care services and ocular health experts among nontraditional patients.  In April 2015, The Huffington Post published a blog article about a woman who sought an ophthalmologist after losing her entire eyesight in one eye.  The woman describes her experience as a point in time that gave her “an appreciation for something else, something I had never given a moment’s thought, as so often happens with watershed moments in our lives.”

Stories like these remind us not to take our eyes for granted.  WebMD suggests following these simple six steps for maintaining good eye health:

1. Eat for Good Vision. Regularly eating these foods can lead to good eye health:

  • Green, leafy vegetables such as spinach, kale, and collards
  • Salmon, tuna, and other oily fish
  • Eggs, nuts, beans, and other non-meat protein sources
  • Oranges and other citrus fruits or juices

2. Quit Smoking. Smoking actually makes you more likely to get cataracts, optic nerve damage, and macular degeneration.

3. Wear Sunglasses. Protect your eyes from the sun’s ultraviolet (UV) rays.

4. Use Safety Eyewear. Especially if you work with hazardous or airborne materials on the job or at home.

5. Look Away From the Computer Screen. Or, try to at least! Staring at the computer screen for too long can cause eyestrain, blurry vision, trouble focusing at a distance, dry eyes, headaches and neck/back/shoulder pain.

6. Visit Your Eye Doctor Regularly. Everyone, even young children, should get their eyes examined regularly.  It helps protect your sight and see your best.

The Dress, The Eye and Color Blindness

the-dress

The eyes are a fascinatingly unique organ whose complexities require years of specialization to understand. Recently there was a highly publicized argument on the internet on the color of a dress. Many saw the dress as blue and black, others as white and gold. It gave everyone the opportunity to learn things about the eye that are normally reserved for those that study it.

First, it’s important to understand that the eye does not see, the brain does. The lens of the eye focuses light entering the eye onto the retina. The retina then sends this information through neural pathways to the visual cortex in the brain. 

When the visual cortex is trying to ascertain the color of certain objects it is essentially making important calculations. The brain takes into account the amount of light and, in this case, the background of the photo to make these calculations.

Though it may cause some online arguments periodically, this is a highly important feature of the eye. Humans can see best during the day, but the color at 7am is different from the color at 7pm, and in relative darkness you can still discern colors of various items.

Color blind people who weighed in on the dress reported seeing a dark color and a pinkish color, which they often see instead of the color blue. Most of the color blind people also reported being happy that normal-sight people got to experience being color blindness for a short period of time.

Color blindness occurs more often in men and is a result of a lack of pigment in the cone cells of the retina that is color sensitive.

For those that remain curious, the dress is actually blue. Those that were adamant about it being white and gold were likely making calculations with a lighter background.

 

What is a Corneal Transplantation?

Keratoplasty, better known as cornea transplant, is the most common hard-tissue transplant. The procedure replaces part of the patient’s cornea with tissue from organ donors.

The cornea is the outermost part of the eye, and is largely responsible for focusing. Successful transplants often help relieve people of eye pain, and can even help people see again. One example of the results of a successful cornea transplant can be se here:

Cornea transplants also have a high success rate, but some peoples’ bodies do reject the donated tissue.

Most of the time cornea transplants are done for patients with damaged corneas, but there are some diseases that affect the cornea and transplants can be very helpful in these situations. Human corneas, for example, can also become cloudy and swell.

As with any serious medical procedure it is important to understand the risks associated with the procedure. Rejection happens in less than 20% of patients. This happens when the immune system attacks the transplanted material. Patients feeling pain or light sensitivity after a transplant should make an appointment with their Ophthalmologist. Other risks include infection and increased swelling, clouding and pressure.

Before the procedure one can expect to undergo a thorough exam so the doctor can take steps to minimize any potential complications after or during the surgery. The doctor will audit medications the patient is taking as well and make sure no complications will arise as a result. The doctor should also seek to make the eye as healthy as possible so no unrelated problems affect the procedure. Finally, the ophthalmologist will measure the patient’s eye to make sure the donated tissue fits.

The good news is that, unlike other organs, corneas generally don’t require long wait times. They usually come from deceased organ donors with healthy eyes. There are a few different types of transplants. Whichever the patient receives, they need to take care and prevent injuries.

What is a Corneal Abrasion?

The Cornea

The Cornea

76er’s Hollis Thompson just got a corneal abrasion during a preseason game. Thompson was hit in the left eye during the game couldn’t play for the rest of the game. But what is a corneal abrasion?

All of the patients we see at the Hargrave Eye Center are there for eyesight issues, but sometimes they are recovering from an injury. A corneal abrasion is the most common eye injury and the problem is that it often goes untreated. It happens because of a disruption of the corneal epithelium or often, and in the case of Thompson, the surface of the cornea is scraped away as a result of external forces. 

The good news is that corneal abrasions heal rapidly so Mr. Thompson shouldn’t worry about getting back to the court but he also shouldn’t take the injury lightly. Deep corneal involvement may result in facet formation or even scar formation. Corneal abrasions can occur in other situations as well. Corneal or epithelial disease, also known as dry eye, other ocular injuries, and contact lens wear are all other common causes of corneal abrasion. Less frequently it is a result of recurrent corneal erosion syndrome.

Abrasions by foreign bodies are defects in the corneal epithelium and are left behind after spontaneous dislodgement of a corneal foreign body. Foreign body abrasions are often caused by a piece of wood while woodworking, glass or plastic, or even vegetable material that is embedded in the cornea. Contact lens abrasions are defects in the corneal epithelium that might remain after removing improperly cleaned, or improperly fitting contact lens’. Spontaneous defects in the corneal epithelium happen without injury or foreign body. The eyes of people that have suffered a previous corneal abrasion or eyes that have a defect in the corneal epithelium often have this issue.

The treatment to cornel abrasions is pretty straightforward, and pain relief is given.

What you need to know about the Methodist-Mayo Clinic Collaboration

By clicking on the links below you will be directed to all of the relevant information about the new collaboration between the Methodist Health System and Mayo Clinic.

MCCN Physician Acknowledgement Form

MCCN Guide brochure

Patients FAQs Phys Pack

The Danger of Eyelash Extensions

Finding Other Diseases

hargraveeyecenter_examIn a recent article by The Miami Herald, eyes and vision are discussed. We all know eyes are an important part of our body because they help us see the world around us. However, what some people might not realize about our eyes is that they could help detect serious health concerns. A routine eye exam could even save someone’s life- like six year old Grace Carr. Grace suffered from frequent migraines and vomiting. When her parents would take her to the doctors, they couldn’t seem to figure out what was wrong with her. One day, her parents noticed that Grace’s eyes were misaligned and they took her over to the Joe DiMaggio Memorial Children’s Hospital. At the hospital, doctors were concerned because they could see themselves that Grace’s optic nerve was swollen and her intracranial pressure was elevated. These type of symptoms could be due to a possibly brain tumor, according to the doctors.

After an MRI test that day, the results showed that Grace did indeed have a benign tumor in her cerebellum. Because of the tumor, the normal flow of spinal fluid was blocked to her optic nerve. Ultimately, the doctors were able to remove the tumor and Grace is now recovering in physical therapy. In Grace’s case, her condition is not the only thing an eye exam can unearth. Eye exams could also reveal that people are suffering from certain issues such as diabetes, allergies and eye cancer. Grace’s parents noticed that their daughter’s eyes were not normal and that they had started drifting when she was six months old. However, now that the tumor was caught early, Grace can now focus on correcting her vision. Without the diligence of her parents in addition to the eye exam, who knows what would have happened to Grace’s vision. Again, this stresses the importance of eye exams for children.

Corneal Transplant Case

Corneal transplants are very important and it is great to hear a story from individuals about when the transplant successfully improves lives.  The Aberdeen News, from Aberdeen, South Dakota, reported of such a case and the summary is below.

In 2012, Terry Mages, an organ donor, could not give her organs when she passed away because she had cancer.  However, her corneas could be used, since blood does not run through them.  Another Aberdeen resident, Bob Karst, received a corneal transplant from a 44 year old Nebraska man who was on life support.  Before receiving the transplant his vision has been deteriorating each year because of a disease and it had gotten to a point where he could barely tell light from dark.  However, since the transplant, he said his vision has been near normal.

hargraveeyecenter_diagramKarst was concerned that the disease would spread to the other eye but was lucky that it didn’t.  He had been on the waiting list for three months before he received the call that they had found a match for him.  Karst still worked normally and drove a car, relying heavily on his good eye before the transplant but afterward his range of vision was greatly increased.

Terry Magnes’ husband Randy is a former surgical technologist at Avera St. Luke’s Hospital in Aberdeen and he mentioned that there are many reasons a cornea can begin to fail.  The damage could result from an eye injury, a virus or bacteria can make the eye cloudy because of a clear shield developing over it, or a disease could mis-shape the cornea which restricts the vision or eliminates it entirely.  Although Karst found out who the donor was for his new cornea, typically the recipient of the donation doesn’t find out who it’s from for privacy protection.  There is also a small amount of transplants happening because, although people are organ donors, they don’t realize that the corneas can be donated.  It is something that St. Lukes’ Hospital hopes will be realized with the cornea transplant technology increase.

Renovations allow for more corneal transplants

1,000 corneal transplants are looking to happen in a newly renovated eye bank in Kettering, Ohio this year, reports the Dayton Daily News.  The amount of transplants will be a 25 percent boost to the numbers from 2013, writes Drew Simon.  The Lions Eye Bank of West Central Ohio moved from its Southtown Boulevard building and is now located at 3309 Office Park Drive.  An open house was held for guests on May 3rd to see the renovations.

hargraveeyecenter_cornealtransplantOpening in 1982 originally, the Lions Eye Bank performed 72 corneal transplants in its first year.  Now, having performed 800 in 2013, the renovations which were donated through transplant partners of the local Lions Clubs, will allow the eye bank to break the 1,000 mark.  $200,000 were spent on the renovations which have offered 10,000 square feet to the new location, which is double the size of its predecessor.

Corneal transplants have increased throughout the years and there are more and more organ donors.  This increases the cornea donation level, increasing the demand for more facilities that can stand up to the challenge.  These findings are from Donate Life and Donate Life Ohio, as they mentioned that numbers have grown significantly over the past decade.

Chief executive officer of the Lions Eye Bank of West Centeral Ohio, Angela Burnham mentions that her staff has been diligent and hardworking to bring better vision to the community in Kettering and around the world.  In the past 15 years alone the eye bank has gone from 350 transplants a year to the goal of 1,000 in 2014, says Burnham.  This is largely in-part to the dedicated workers at the eye bank, which added three new full-time employees bringing their number to 14.  A statistic from the article shows that the American Academy of Ophthalmology (AAO) reported 46,196 corneal transplants took place around the country in 2011.