Center For Sight

Cornea Care

CORNEA CARE

The cornea is the clear, outermost tissue of the eye that functions like a window, allowing light to enter the eye and helps focus images on the retina. It also serves to protect the eye from the environment and helps filter out some of the sun’s most damaging ultraviolet (UV) rays. In order to function properly and provide the best vision, the cornea must remain healthy and clear. When the cornea is damaged either by injury, disease or due to hereditary conditions, it may become swollen or scarred. These scars may cause the cornea to scatter or distort light, resulting in reduced vision, sometimes to the point of blindness. If the cornea becomes cloudy or distorted, the only way to restore sight may be a corneal transplant.

Our two board-certified corneal surgeons provide the most advanced cornea care in Southwest Florida.

William J. Lahners, M.D., F.A.C.S. received his medical degree from Louisiana State University and completed his Corneal Fellowship program at the prestigious Phillips Eye Institute in Minneapolis. Dr. Lahners joined an elite group of eye surgeons when he became the first surgeon on Florida’s west coast to perform All-Laser LASIK and the fifth surgeon in the United States to perform femtosecond laser assisted corneal transplantation surgery.

Joaquin O. De Rojas, M.D. is a board-certified, fellowship-trained cataract, refractive and corneal surgeon. He earned his bachelor’s degree from Boston College, graduating Magna Cum Laude in the Honors Program, and then received his medical degree from the Perelman School of Medicine at the University of Pennsylvania. He completed his surgical internship and ophthalmology residency training at Columbia University Medical Center, where he was Chief Surgical Resident, followed by a Cornea, External Diseases, and Refractive Surgery fellowship at the Johns Hopkins Wilmer Eye Institute.

There are two types of corneal transplantation: full thickness and partial thickness. The use of the IntraLase femtosecond laser to perform full thickness transplants make the procedure safer, more accurate, and with faster recovery and fewer complications. With a full thickness transplant, the diseased cornea is removed and a full thickness donor cornea is sutured into place.

When the corneal disease is limited to the “endothelium” layer of the cornea, as in Fuchs dystrophy, a hereditary condition, Dr. Lahners or Dr. De Rojas may recommend a DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) transplant. DSAEK is a partial thickness corneal transplant that replaces only the diseased posterior layer of the cornea (the endothelium). This procedure is performed through a smaller incision and involves stripping away the damaged endothelium tissue and replacing it with a thin disc of healthy donor endothelium tissue. Because of the smaller incision, many people experience improvement in their vision within weeks and sutures may not be required.

Dr. De Rojas is skilled in the most advanced technique for partial thickness corneal transplantation, called DMEK (Descemet Membrane Endothelial Keratoplasty). This technique has been shown to result in the highest quality of vision and the fastest recovery time for patients with decompensated Fuchs Dystrophy and corneal swelling. Dr. De Rojas is one of the few surgeons in Florida who performs this state-of-the-art treatment.

Corneal Cross Linking is a minimally invasive outpatient procedure, performed in Center For Sight’s ambulatory surgery center in Sarasota. Patients receive riboflavin (Vitamin B2) eye drops until the drops have fully saturated the cornea. Following the riboflavin drops, the patient will look at an ultraviolet (UV) light for two to four minutes per eye. The ultraviolet (UV) light triggers the riboflavin, resulting in cross linking of collagen fibers of the cornea, strengthening the cornea. Only one treatment is necessary to see results. Cross-linking, which has been performed in Europe since 2003, is considered the standard of care around the world for keratoconus and corneal ectasia following refractive surgery.
Keratoconus, often referred to as ‘KC’, is a non-inflammatory eye condition in which the typically round dome-shaped cornea progressively thins and weakens, causing the development of a cone-like bulge and optical irregularity of the cornea. This causes ‘static’ in your vision and can result in significant visual impairment.

Keratoconus typically first appears in individuals who are in their late teens or early twenties, and may progress for 10-20 years, and then slow or stabilize. Each eye may be affected differently. In the early stages of keratoconus, people might experience:

  • Slight blurring of vision
  • Distortion of vision
  • Increased sensitivity to light

The cornea is responsible for focusing most of the light that comes into the eye. Therefore, abnormalities of the cornea, such as keratoconus, can have a major impact on how an individual sees the world, making simple tasks such as driving a car or reading a book very difficult.

Corneal Disease Overview
Fuchs’ Dystrophy
Keratoconus
Corneal Ectasia
DSEK DMEK
Corneal Crosslinking
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