Cornea

Typically, a cornea specialist is an ophthalmologist who underwent the typical training of a four-year medical school program, followed by at least one year of medical or general surgical internship, a three-year general ophthalmology residency, and finally a year of subspecialty fellowship training in cornea. Dr. Gene Moss is Piedmont Eye Center’s cornea specialist, who provides the most advanced treatments in corneal disease available. In addition, Dr. Moss provides advanced cataract surgery and sees patients at our Bedford location as well as our Lynchburg office.

The cornea is the clear part of the front of the eye overlying the pupil. It is that part of the eye that a contact lens would rest upon.

A healthy cornea is clear and allows for good vision. There are many hereditary and acquired corneal diseases and conditions that can affect the clarity of the cornea. Trauma that causes corneal scarring is an example of an acquired condition that can affect vision. An example of a common hereditary corneal disease is a condition known as Fuch’s (pronounced ‘Fooks’) corneal dystrophy, named after the German ophthalmologist that described it. This condition affects the innermost lining of the cornea of both eyes and typically progresses very slowly over years affecting vision in later stages.

Corneal transplant surgery is a procedure performed to replace the diseased cornea with a healthy ‘donor’ cornea. Tissue is acquired through a donor eye bank and prepared for use when needed by the surgeon. Without organ donation, this surgery would not be possible. The typical method used in conventional transplantation requires the surgeon to remove the entire central diseased cornea followed by suturing the donor cornea into place. A more advanced method, known as DSAEK, is newer technique that may offer a better option for certain patients. It involves replacing the innermost lining of the diseased cornea with healthy donor tissue.

Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) is a new technique of corneal transplantation that, compared to conventional methods, provides for more rapid visual improvement and healing while reducing the risk for serious complications. The conventional method of corneal transplantation, requires a full thickness replacement of the central cornea- that front part of the eye that overlies the pupil and which a contact lens would rest upon. This procedure is more complex and requires sutures to secure the new tissue into place. With DSAEK, only the most inner lining of the patient’s cornea is replaced and can be done through a small incision that requires minimal suturing.

Descemet’s membrane endothelial keratoplasty (DMEK) is the latest and most exciting option available to treat damaged corneas. This newer form of corneal transplant procedure uses extremely thin donor tissue (just 5% of corneal thickness) and provide more patients with 20/20 or 20/25 than DSEK. In fact, DMEK provides 20/25 or better vision for about 3 out of 4 patients.  Additionally, the risk of rejection is reduced with DMEK to less than 1 percent.

Possible candidates for DMEK: Fuch’s endothelial dystrophy, posterior polymorphous membrane dystrophy, bulls keratopathy, congenital hereditary endothelia dystrophy and more.