DSEK Procedure Safer Alternative To Total Cornea Transplant

Three months ago, Harlon Graves Jr. of Tylertown could see only light, a few colors and shadowy shapes.

Cornea degeneration had robbed the 72-year-old of his vision and diminished his ability to enjoy simple pleasures, such as reading or watching television. Following an endothelial cornea transplant at the University of Mississippi Medical Center, Graves now can watch the evening news without difficulty.

“It’s like a miracle,” he said. “I can’t express to you what this means to me. I went from being blind to being able to see.”

The Medical Center is the only facility in the State of Mississippi and one of the few facilities in the Southeast that offers Descemet’s stripping with endothelial keratoplasty (DSEK) – transplantation of the back of the cornea. The procedure has fewer complications and a shorter recovery than a complete cornea transplant, which would have been Graves’ only option a few years ago.

Dr. Bo Huang, assistant professor of ophthalmology, who performed Graves’ surgery, said the advantages of DSEK are no corneal stitches, no additional astigmatism, a decreased rate of postoperative complications and minimized risk for significant eye trauma in the future.

“The old procedure would take years for a patient to recover. This new procedure takes a few weeks,” he said.

Graves said he suffered no pain, only tenderness and redness in the eye for a few days. He is pleased with the results.

“I was hoping for the best, and I got it. Eyesight is so important. You don’t realize it until it’s gone,” Graves said.

Cornea degeneration is caused by the loss of cells. Huang said each person is born with a certain number of cornea cells that degenerate over time. The cells keep the cornea clear, but when they fall below a certain number, the cornea becomes cloudy, which is known as age-related degeneration of endothelial cells.

In the DSEK procedure, a thin piece of donor corneal tissue containing endothelial cells and posterior corneal stroma is made with a special device called microkeratome. The tissue is placed in the eye through a small incision on the side of the eye.

Huang said the surgery is safer because the new cornea is inserted through a small incision rather than a complete opening of the front part of the eye, reducing the chance of a devastating hemorrhage during the surgery or an infection.

In Graves’ case, the ultrasound used during an earlier cataract surgery damaged the cornea cells, causing vision loss. The DSEK procedure replaced those damaged cells, significantly changing the patients’ vision.

“They can make things out much better. It would be a major improvement,” Huang said.

Both Huang and Dr. Connie McCaa, professor of ophthalmology and director of research, are cornea specialists and perform the DSEK procedure. For more information, call the Department of Ophthalmology at 5-3248.

—    Patrice Sawyer Guilfoyle (1-30-06)

2006-01-30 00:00:00 2800