Cornea

A wide range of treatments to help you heal.

Your corneas need to stay healthy

The cornea is the clear, dome-shaped tissue at the front of the eye. If you wear contact lenses, they sit on top of the cornea. Sometimes it gets damaged by infectious or inflammatory conditions, trauma or other problems that can result in vision loss.

The main problems include:

  • Corneal ectasia like keratoconus.
  • Swelling or bullous keratopathy.
  • Buildup of substances as in corneal dystrophy.
  • Inflammation (keratitis).
  • Infection.
  • Injury and scarring.
cornea_smiling_man

The right treatment
for your case

 
Our eye care specialists can do whatever it takes to treat your cornea, from temporary or short-term solutions to more definitive repair. This depends on the underlying disease in addition to the extent of the problem. We often use multiple treatments simultaneously or in a staged process to achieve the best outcomes.

The right treatment for you may include surgery. In addition to corneal transplants, our fellowship-trained corneal specialists can perform any corneal surgery using the latest technology. Make an appointment today so we can start helping you heal.

Ocular surface disease and infections

Certain conditions harm your cornea, referred to as ocular surface diseases or infections, which may cause vision loss. We can often treat them and restore your vision if you come see us as soon as you notice a problem.

Fuchs’ corneal dystrophy is a genetic condition affecting the inner layer of the cornea, called the endothelium. Normally the endothelium pumps fluid out of your cornea, keeping it clear, but with this corneal dystrophy, the endothelial cells degenerate too rapidly, resulting in painful swelling and blurriness. We treat corneal dystrophy by nonsurgical options or, if necessary, a partial corneal transplant (either penetrating keratoplasty or DSAEK—see below).

We can also treat:

  • Blepharitis, infection or inflammation of your eyelid.
  • Herpes simplex virus.
  • Bacterial infections.

We are also experts at treating dry eye, which can be caused by a variety of conditions. Read more about dry eye and our treatments here.

Keratoconus and ectasia of the cornea

 
Keratoconus, the most common type of corneal ectasia, is a condition when the cornea becomes abnormally thin and bulges out like a cone, resulting in severe distortion of your vision. If caught early, we can perform corneal collagen crosslinking (CXL), a procedure in which riboflavin is placed on the cornea and activated by UV light. CXL is proven to slow the progression of keratoconus. Other treatments include the use of special contact lenses to improve vision (see below). In rare cases, a corneal transplant is needed.

cornea_surgeon

For some situations, corneal transplantation is the only way to restore vision. In a corneal transplant, we remove all of your damaged cornea and replace it with a healthy, donated cornea. There are four main types of transplants:

  1. Penetrating keratoplasty (PK): Our surgeon removes a full-thickness section of the central part of your damaged cornea, replacing it with a healthy cornea using sutures. Sutures may stay in place for up to a year, sometimes longer. It is likely you will need specialty contact lenses to achieve your best possible vision.
  2. Deep anterior lamellar keratoplasty (DALK): In this surgery, the surgeon removes the front part of your damaged cornea, called the stroma, and replaces it with a healthy stroma. Sutures are used to secure the cornea in place. The healing process is similar to a PK.
  3. Endothelial keratoplasty: Partial corneal transplant, performed when the endothelial cells (cells on the innermost layer of the cornea) are damaged or dysfunctional. There are two main types—your surgeon will know which type you need:
    1. Descemet membrane endothelial keratoplasty (DMEK): Your surgeon removes the back part of the cornea, called the Descemet’s membrane, and the single layer of cells on the inside of the cornea, called the endothelium. Your surgeon replaces your damaged Descemet’s membrane and endothelium with healthy ones, but without the stroma.
    2. Descemet-stripping automated endothelial keratoplasty (DSAEK): This is similar to DMEK, but your surgeon also removes a very small amount of your stroma and replaces it with a healthy section of stroma, Descemet’s membrane and endothelium.
  4. Keratoprosthesis: In some cases, a corneal transplant is not possible. A keratoprosthesis is an artificial cornea that can be used in some situations to restore vision.

Because transplants involve tissue from another patient, there is a risk of transplant rejection. Penetrating keratoplasty has the highest rate of rejection, but fortunately the rate is only 10 percent per year. It is important for you to know that even if you have a rejection episode, most rejections can be treated medically as long as they are caught early. That’s why we will set up a thorough follow-up schedule with you.

Certain corneal conditions can be improved by a specialty contact lens fit. We specialize in patients who have keratoconus and other forms of corneal ectasia. After treating the underlying problem with your cornea, we will customize contact lenses to help restore more of your vision.

cornea_exam

You’ll get a personalized treatment plan

 
Your eye care team will create a custom plan for your unique case. Don’t let an issue with your cornea(s) hold you back any more. Make an appointment today so you can get back to your extraordinary life.

Cornea Care

Dr. Ronald E. Wise MD, Ophthalmologist | UCHealth

Your eyes are in good hands

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