
Cornea Care
- The cornea is the transparent tissue at the front of the eye. It acts as the eye’s outermost lens and helps to shield the rest of the eye from germs, dust, and other harmful matter.
- Keratoconus, the most common cornea ectasia disorder, is a progressive eye disease that causes abnormal corneal change in which the cornea gradually becomes steeper and, eventually, cone-shaped.
- Treatment options for corneal disease or damage include corneal transplants, Corneal Collagen Cross-Linking (CXL) and Intacs Corneal Implants. We are proud to be one of the few practices in the region offering CXL.
What is the Cornea?
The cornea is the transparent tissue at the front of the eye. It acts as the eye’s outermost lens and helps to shield the rest of the eye from germs, dust, and other harmful matter. The cornea contributes between 65-75 percent of the eye’s total focusing power and also serves as a filter, screening out some of the most damaging ultraviolet (UV) wavelengths in sunlight. The transparency and shape of the cornea is vital for good vision and any alteration in this can result in poor vision or blindness. Although the cornea is clear and seems to lack substance, it is actually a highly organized group of cells and proteins. To see well, all layers of the cornea must be free of any cloudy or opaque areas.
Fuchs’ Dystrophy
Fuchs’ dystrophy is a disorder that effects healthy cells in the cornea, resulting in a buildup of fluid and swelling that typically progresses to effect both eyes. Symptoms include glare, blurred or cloudy vision, and eye discomfort. Fuchs’ dystrophy typically effects patients over 50, is slightly more common in women than men, and can be inherited from family members.
Keratoconus
Keratoconus is a progressive eye disease that causes the cornea to gradually become steeper and, eventually, cone-shaped. It is the most common cornea ectasia disorder. As the disease progresses, the quality of the patient’s vision deteriorates. Keratoconus, which affects approximately 1 in 2,000 people, can make normal activities such as driving and reading very difficult to perform, even with glasses or contacts.
Keratoconus normally affects both eyes although it typically progresses at different rates. In most patients, keratoconus begins during the teenage years and slowly worsens before stabilizing when the patient reaches their 30’s or 40’s. No one knows the cause of keratoconus. However, there is evidence that the disease has genetic origins, which may be made worse by environmental factors.
Other Diseases and Injuries Affecting the Cornea
The doctors at John-Kenyon can treat a variety of diseases and eye injuries that may affect the cornea, including:
• Scarring from infections, such as eye herpes or fungal keratitis
• Cornea ectasia disorders, including keratoconus
• Hereditary factors or corneal failure from previous surgeries
• Thinning of the cornea and irregular shape
• Chemical burns on the cornea or damage from an eye injury
• Excessive swelling (edema) of the cornea
How We Treat It
Corneal Transplant
John-Kenyon offers several different types of selective corneal transplant techniques, only removing the tissue that’s damaged and leaving the healthy tissue behind. The transplant method used will depend on the underling disease and will be tailored to your specific needs. Methods include:
- Penetrating keratoplasty (PK): During traditional corneal transplant surgery, or penetrating keratoplasty, the damaged piece of full-thickness tissue is removed and a matching piece of healthy donor tissue is then stitched into place.
- Deep anterior lamellar keratoplasty (DALK): This procedure replaces only the top layers of the cornea, leaving behind unaffected healthy cornea. The procedure is frequently used with patients who have superficial corneal scarring or conditions like keratoconus.
- Endothelial keratoplasty (EK): Endothelial keratoplasty is a newer version of corneal transplant surgery where the innermost layer of the cornea is replaced, leaving the top layer of healthy corneal tissue intact. Benefits of EK include a drastically reduced recovery period, as the surface of the cornea is untouched.
Corneal Collagen Cross-Linking
John-Kenyon is thrilled to be one of the few practices in the region offering Corneal Collagen Cross-Linking (CXL), a treatment available to patients over 12 years of age suffering from corneal ectatic disorders like keratoconus.
The procedure, which typically lasts one to two hours, uses a combination of Riboflavin drops and ultraviolet light to create ‘cross links’ in the corneal architecture, strengthening the cornea itself and helping prevent the progression of keratoconus.
Intacs Corneal Implants
Intacs corneal inserts are a minimally invasive surgical option used primarily in the treatment of keratoconus. Two tiny, clear crescent-shaped pieces of plastic polymer are inserted into the cornea, flattening the steep part of the cornea. Similar to LASIK, the procedure takes roughly 15 minutes and is done on an outpatient basis.

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