![\"structures_of_the_eye_2\"](\"http:\/\/pilgrimworks.com\/blog\/wp-content\/uploads\/2018\/01\/structures_of_the_eye_2.jpg\")
<\/a><\/p>\nUntil about 2000 the only available treatment was\u00a0full-thickness penetrating keratoplasty (PK). This involved removing a large portion of the cornea and replacing it with a donor, sewed in with a dozen stitches and taking a year to heal. Fortunately, this is NOT the procedure I will be having. See the photo below with the visible stitches around the eye.<\/p>\n
Over the next 15 years doctors learned how to transplant just the inner layers of the cornea through a small incision, resulting in much quicker healing and much better vision. They have gradually decreased the thickness of the transplant until now DMEK, the procedure I will have, transplants only the inner two layers, about\u00a0 10 microns thick (illustration C in the drawing below).<\/p>\n The procedure is out-patient and takes less than an hour. To keep the graft sticking to the cornea they inject a gas bubble to hold it in place.<\/p>\n Donaghy CL, Vislisel JM, Greiner MA. An Introduction to Corneal Transplantation. May 21, 2015; Available from: http:\/\/EyeRounds.org\/tutorials\/cornea-transplant-intro\/<\/p>\n To keep the bubble from floating to the top of the eye (as in the photo above), I need to lie flat on my back for a day, maybe two or three. As the bubble goes away, if the graft takes hold and starts working, my vision will quickly return to normal. I hope to return to school one week later. Within just a few weeks many patients are back to 20\/20 vision.<\/p>\n This is a transplant of tissue from an donor eye (a big thank you to some anonymous organ donor), so there is a risk of rejection. For this reason I will take daily steroid eye drops indefinitely. That is a small price for good vision.<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" On February 1, 2018 I am scheduled to have eye surgery, a procedure known as Descemet\u2019s membrane endothelial keratoplasty (DMEK). Here for the curious is a detailed explanation. The problem is that the endothelial layer of my cornea is dying. … Continue reading <\/a><\/p>\n<\/a><\/p>\n<\/a><\/p>\n