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Cornea Treatments

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The cornea protects your eye from contaminants like dust and germs and filters UV rays to protect your eyes. As the eye’s outermost lens, the cornea bends the light into the primary lens of your eye to refocus the light onto the retina. 

Vold Vision offers a variety of options to allow the most effective treatment for corneal diseases. As the first provider of corneal collagen cross-linking for keratoconus and corneal ectasia in the Northwest Arkansas area, we are pleased to announce the minimally-invasive, preventative treatment. 

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diseases and how we treat them.

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What are Corneal Diseases?

The cornea’s main job is refraction, acting as a lens to bend or refract light to the retina. With a refractive error or corneal disease, the light bends incorrectly and is not focused on the retinal surface, causing objects to look out of focus or become dull due to a cloudy cornea. 

There are several eye conditions explicitly related to the cornea that can be diagnosed and treated at Vold Vision, including:

Keratitis is damage to the cornea from infection or inflammation. Keratitis can reduce acuity, cause discharge, and erode the cornea. In some cases, scarring can harm vision and could ultimately require a corneal transplant. 

People with dry eye produce fewer or lower-quality tears, so the eyes can’t stay moist enough and become uncomfortable. The main symptom is a scratchy or sandy feeling as if something is in the eye. 

There is a large spectrum of dry eye, ranging from insufficient tears to moderate and severe ocular surface disease involving inflammation and breakdown of the ocular surface. Dry eye and ocular surface disease are complex problems that need to be diagnosed and treated with attention to detail to improve symptoms and vision.  

There are over 20 corneal dystrophies that may cause clouding of the cornea. Some cause severe problems, while others are minor and only caught during a routine eye exam. Some of the more common dystrophies are Fuch’s dystrophy, which leads to corneal swelling and may require a corneal transplant, and keratoconus, the most common dystrophy. 

Keratoconus is an eye condition where the cornea thins and weakens, causing the development of a cone-like bulge and optical irregularity. The abnormality causes “static” in your vision and can result in significant vision impairment.

Other types include Granular, Lattice, and Map-Dot-Fingerprint (or anterior basement membrane) dystrophy. 

This common virus can cause cornea pitting and ulceration, inflammation, scarring, damage to other eye parts, and elevated eye pressure. 

Shingles is also a herpes virus that causes problems when the virus that causes chickenpox reactivates. It can affect the cornea by causing inflammation, scarring, surface ulceration, and other eye problems.  

Pterygium is the development of scar tissue from the white part of the eye onto the transparent cornea. It can cause astigmatism, corneal warpage, and clouding of the vision. Pterygia can be removed, and tissue grafts and anti-scarring mediations can prevent regrowth. 

How Does Cornea Treatment Work?

Depending on what’s happening with your cornea, Dr. Vold will carefully determine the most effective technique to restore your vision. Procedures broadly fall into two main categories, full (PKP) or partial thickness (DALK, DSAEK, or DMEK).

DSAEK

Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) restores the cornea’s clarity from swelling, edema, or inflammation. With DSAEK, Dr. Vold can perform a partial cornea replacement surgery, resulting in quicker recovery than full-thickness and more traditional techniques.

DMEK

Vold Vision also offers Descemet’s Membrane Endothelial Keratoplasty (DMEK)–the thinnest and most recent cornea transplant available. While DMEK is similar to DSAEK, the cornea tissue transplanted is only about 10 microns thick or 1/100th of a millimeter. By incorporating the thinnest tissue possible, DMEK leads to a faster recovery, a decreased risk of rejection, and a greater chance of attaining 20/20 vision.

Penetrating Keratoplasty

Penetrating Keratoplasty (PK), a full-thickness cornea transplant, uses a donor graft to restore the cornea. In some cases, partial thickness transplants supplant PK due to reduced scarring and recovery. For example, Deep Anterior Lamellar Keratoplasty (DALK) is a partial-thickness transplant that replaces the stroma, or the outer layers of the cornea, leaving the inner layers intact.

Ocular Surface Reconstruction

In cases of severe dry eye, ocular surface disease, or certain corneal dystrophies, reconstruction of the ocular surface may be required to improve painful erosions or a chronic non-healing eye surface and ultimately repair by planting a protective contact lens or healing amniotic membrane onto the eye surface.

Cross-Linking

Corneal Cross-linking is a minimally invasive procedure, lasting approximately one hour. The Avedro system we offer at Vold Vision is the only FDA-approved cross-linking system in the United States.

During the procedure, riboflavin, a vitamin solution, is dripped onto the eye, followed by shining a UV light onto the eye for 30 minutes. At the end of the procedure, Dr. Vold places a contact lens to keep the eye comfortable while the eye heals and prescribes antibiotic and anti-inflammatory drops for several weeks. 

In rare cases, the procedure may need to be repeated a second time. In many cases, cross-linking may prevent the need for future corneal transplantation or other more invasive treatments due to these conditions.

While the treatments for cornea diseases and conditions are varied, some of the benefits of any treatments offered at Vold Vision include:

  • Complete 360-Eye Exam for accurate diagnosis
  • Early preventative treatments avoid the need for corneal transplants
  • Prevent vision loss
  • Slow down or stop eye conditions
  • Improved corneal diseases and symptoms

Your recovery time and experience depend on the type of cornea treatment you receive. Some, such as DMEK, require shorter downtime than their counterparts. 

For corneal cross-linking, you should not rub your eyes for the first five days and manage any pain with Tylenol. Dr. Vold will place a bandage contact lens on the eye’s surface to protect the newly treated area. If your bandage contact lens falls out or becomes dislodged, you should not replace it and contact your physician immediately.

You will wear an eye patch for most transplants for one to four days. If you received DSAEK and DMEK, you might need to lie on your back while sleeping. Follow-up appointments allow Vold Vision to check for complications and aid your healing process. Dr. Vold may prescribe eye drops to stop inflammation. 

If you are experiencing symptoms such as lost clarity of vision, discharge, itchy or scratchy eyes, contact Vold Vision for a 360-eye exam as soon as possible. Before any procedure, you will first receive a complete eye exam. You will also receive specific instructions on the best preparation for your treatment.

Corneal transplants typically restore or significantly improve your sight. You may be an excellent candidate if you have Fuch’s dystrophy, keratoconus, a thinning cornea, corneal scarring, clouding, or swelling. 

Patients who have been diagnosed with progressive keratoconus or corneal ectasia may be a candidate for corneal cross-linking. The safety and effectiveness of corneal cross-linking have not been established in pregnant or breastfeeding women or patients younger than 14 or older than 65.

 

Why Should I Go to Vold Vision for Corneal Treatment?

Not everyone’s corneas stay clear their entire lives. If something occurs that requires corneal treatment, now is the time to take that first step to clearer eyesight. At Vold Vision, our team of friendly and patient professionals, led by Dr. Vold, will bring all their experience and technology to diagnose accurately and successfully treat your condition so you can reclaim the best possible vision. 

Dr. Steven Vold is board-certified by the American Board of Ophthalmology and is a specialist in managing corneal disease, cataracts, and glaucoma. Vold Vision also offers advanced contact lens and scleral lens fitting for keratoconus and corneal transplantation services for a full spectrum of treatments for keratoconus, ectasia, and other corneal disorders.

Corneal Cross-Linking FAQ

Yes, but your doctor will apply topical anesthesia to numb the eye before removing the epithelium. 

Yes, you will be awake during the treatment, but relaxing medication and numbing anesthetic drops prevent discomfort.

The most common ocular adverse reactions in any cross-linked eye were haze, inflammation, fine white lines, disruption of surface cells, eye pain, reduced visual acuity, and blurred vision. To learn more, talk to your healthcare provider about corneal cross-linking.

The FDA-approved product labeling can be found at www.Avedro.com. Please report any negative side effects of prescription drugs to the FDA. Visit MedWatch or call 1-800-FDA-1088.

Take the Next Step

To learn more about the cornea, schedule a consultation with one of the providers at Vold Vision. Throughout your entire laser vision correction journey, you will have your very own Vold liaison to assist you with any questions you have. Our patient care counselors are available by text, phone, or email and no question is too small for them to answer. To schedule a consultation, fill out the consultation request form below, or call or text (479) 442-8653.

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