Descemet Membrane Endothelial Keratoplasty (DMEK)
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Descemet Membrane Endothelial Keratoplasty (DMEK)
The RxSight® Light Adjustable Lens™ (LAL) is the first and only FDA-approved intraocular lens that can be customized to your specific visual needs after cataract surgery.
Customized results
The Light Adjustable Lens (LAL) offers unparalleled flexibility by allowing post-surgical adjustments to fine-tune vision to the patient’s needs. This revolutionary lens can be modified with UV light after implantation, ensuring patients achieve optimal visual clarity that can be customized even after surgery. Dr. Manusis can preview and adjust your vision to your own personal visual requirements after the lens has been implanted.
DSEK is a partial-thickness cornea transplant procedure that involves selective removal of the patient's Descemet membrane and endothelium, followed by transplantation of donor corneal endothelium and donor corneal stroma. In DMEK, no stroma is transplanted.
Who is Partial Corneal Transplant for?
The procedure is used to treat corneal swelling or edema in the setting of endothelial dysfunction. A few causes may be Fuchs corneal dystrophy, pseudophakic bullous keratopathy, endothelial failure in the setting of prior intraocular surgery, or a previous failed corneal transplant.
What to expect
A partial corneal transplant offers many advantages over full-thickness transplantation. It is a safer and shorter surgical procedure. It has relatively rapid healing time and visual rehabilitation. Like a full-thickness transplant, it requires lifelong care with close follow-up and use of topical drops. Rejection can still occur with a DSEK, and one must seek care in case of redness, light sensitivity, and blurred vision.
Corneal cross-linking is a surgical procedure aimed at:
What does the procedure involve?
Riboflavin (Vitamin B2) is applied to the eye every 5 minutes for 30 minutes, and then the cornea is illuminated with UV-A light for approx. 10 – 30 minutes. The eye is covered with a bandage contact lens which is removed 5 to 7 days after the procedure. The cornea will be examined and scanned at frequent intervals to monitor for its stability.
Signs you may have dry eye syndrome include:
Allergies
Seasonal or environmental allergies (like pet dander) cause eye dryness and redness.
Medications
Medicines like antidepressants, antihistamines, decongestants and oral contraceptives can reduce your tear production.
Blepharitis
Blepharitis is an inflammatory condition of eyelid margins associated with meibomian gland dysfunction and poor lipid production resulting in premature tear film evaporation and dry eye.
Diabetes
People with diabetes have decreased corneal sensation and therefore do not produce enough tears to provide an adequate tear film.
Autoimmune diseases
Refractive surgery
It is now established that post-LASIK patients will experience dry eyes in the short term. Once corneal nerves repopulate, dry eye symptoms typically improve.
Contact Lenses
Long-term use of contact lenses decreases sensation, especially when worn overnight. Various treatment options are available to ensure comfortable long-term contact lens tolerance.
Eye fatigue
Long-term computer use and reading both have one thing in common — a reduced rate of blinking. After a while, the eyes feel fatigued, and vision blurs due to increasing dryness.
Environment
Airplanes, sitting near air-conditioners, prolonged use of computers, or forced air heating, driving a car, and lack of sleep all can cause dry eye symptoms.
Dry eyes also have dietary components. Increasing water intake and decreasing caffeine and alcohol consumption will most likely improve tear film.
Eyelid disorders
Poor eyelid closure, sleeping with eyes partially open, or having a poor blinking reflex can lead to eye exposure and dryness.
Age
People older than 50 are at a higher risk for dry eye. Tear production and meibum (oil) production decline with age.
Sex
Women are more likely than men to have dry eye due to fluctuating hormones, especially during pregnancy and menopause.
Smoking
Smoking and exposure to second-hand smoke increase your risk of eye irritation and dryness.
Vitamin A and Omega-3 Deficiency
Low levels of vitamin A or Omega-3 fatty acids can contribute to dry eye syndrome.
Autologous Serum Eye Drops
Serum eye drops come from the patient’s own blood serum. They resemble natural tears and contain critical biological factors that can help treat dry eye disease.
Eyelid Thermal Treatment (TearCare®):
TearCare is an eyelid thermal treatment that combines localized heat therapy with manual compression of the eyelids. It treats meibomian gland dysfunction and improves oil production.
Medicated Eye Drops
Your provider may prescribe eye drops that help your eyes increase tear production.
Ointment
Medicated ointment helps to reduce inflammation on the surface of your eyes.
Special contact lenses
Special contact lenses can help treat ocular surface diseases, including dry eye disease.
Tear Duct Blocking
Small silicone plugs are placed in your tear ducts to slow the drainage of your tears. This helps your eyes retain more moisture and helps the tear film better lubricate your eyes.
BlephEx
A special medicated brush cleans eyelids to remove debris and bacterial toxins.
More info can be found at: Dry Eye Statistics
Penetrating keratoplasty replaces the full-thickness cornea with donor tissue to restore vision in cases of scarring, keratoconus, or severe corneal disease.
Keratoconus is a progressive corneal degenerative condition where the cornea becomes thin and weak, impacting vision. Corneal Crosslinking (CXL) can reduce further progression.
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