Corneal
services

Chico Eye Center has the only corneal specialist between Redding and Sacramento.

The Cornea

The cornea is a thin, clear, spherical layer of tissue on the surface of the eye that provides a window for light to pass through. In a healthy eye, the cornea bends or refracts light rays to help them focus precisely on the retina in the back of the eye.There are many diseases that can affect the cornea, causing pain or loss of vision. Disease, infection or injury can cause the cornea to swell (called “edema”) or degrade (become cloudy and reduce vision).Treatment for corneal disease can take many forms, depending on the underlying problem as well as the patient’s preferences. Some conditions may resolve on their own and many can be treated with medication. In other cases, a corneal surgery may be necessary in order to prevent blindness or restore a severely damaged eye.

Common Conditions

  • Keratoconus – a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape. In patients with keratoconus, the cone-shaped cornea deflects light and causes distorted vision.
  • Fuch’s dystrophy – an inherited eye disease that causes the cells in the innermost layer of the cornea to deteriorate, leading to distorted vision and corneal swelling. As these cells continue to deteriorate, fluid will continue to build up and vision will worsen. Once these cells are lost, they do not grow back.
  • Pterygium – a benign growth of the conjunctiva (the lining of the white part of the eye) that grows on to the cornea and partially covers the iris (colored part of the eye). Patients with a pterygium often first notice the condition because of the appearance of a lesion on their eye or because of dryness, itchiness, irritation, tearing, and/or redness.
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Cornea Abrasion

Map-Dot Fingerprint

Fuch's Dystrophy

Ocular Surface Disease

Corneal Surgeries

Penetrating Keratoplasty (PKP)

Standard corneal transplant surgery was first developed over 100 years ago, and the 90% success rate reported today is based on numerous refinements to this basic technique. Corneal transplants may be necessary for patients whose vision is severely impaired due to scarring, swelling, hereditary conditions, complications from prior eye surgeries, or a cornea with an abnormal curvature that cannot be treated with specially fitted contact lenses. Corneal transplants are the most common and successful transplant surgeries performed in the United States, with over 40,000 procedures done each year. With PKP, the full thickness of the host cornea is removed as a disk and replaced with a donor cornea that is sutured into place with stitches that are smaller than a human hair. These donor corneas are provided by eye banks throughout the United States and are carefully reviewed to check for viruses and clarity before being released for transplantation.

Descement Stripping Automated Endothelial Keratoplasty (DSAEK)

This newer corneal procedure was first proposed in the 1950's, but did not become a widespread technique until the early 2000's. It is not an appropriate technique for all patients with corneal disease. However, if it is indicated, it can significantly reduce the time to full visual recovery. This is primarily done for patients with a condition called Fuch’s dystrophy. The DSAEK technique involves making a small 5 mm incision into the cornea. Then, the diseased posterior cells of the cornea (endothelium) are removed and replaced with pre-cut donor corneal cells. An air bubble instead of sutures is used to keep the graft in place.

Penetrating Keratoplasty (PKP)

Standard corneal transplant surgery was first developed over 100 years ago, and the 90% success rate reported today is based on numerous refinements to this basic technique. Corneal transplants may be necessary for patients whose vision is severely impaired due to scarring, swelling, hereditary conditions, complications from prior eye surgeries, or a cornea with an abnormal curvature that cannot be treated with specially fitted contact lenses. Corneal transplants are the most common and successful transplant surgeries performed in the United States, with over 40,000 procedures done each year. With PKP, the full thickness of the host cornea is removed as a disk and replaced with a donor cornea that is sutured into place with stitches that are smaller than a human hair. These donor corneas are provided by eye banks throughout the United States and are carefully reviewed to check for viruses and clarity before being released for transplantation.

Descement Stripping Automated Endothelial Keratoplasty (DSAEK)

This newer corneal procedure was first proposed in the 1950's, but did not become a widespread technique until the early 2000's. It is not an appropriate technique for all patients with corneal disease. However, if it is indicated, it can significantly reduce the time to full visual recovery. This is primarily done for patients with a condition called Fuch’s dystrophy. The DSAEK technique involves making a small 5 mm incision into the cornea. Then, the diseased posterior cells of the cornea (endothelium) are removed and replaced with pre-cut donor corneal cells. An air bubble instead of sutures is used to keep the graft in place.
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Corneal Cross-Linking (CXL)

Cross-Linking is a minimally invasive outpatient procedure that combines the use of ultraviolet (UVA) light and riboflavin (vitamin B2) eye drops to add stiffness to corneas which have been weakened by disease or refractive surgery. 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. Our practice is proud to offer patients the first and only therapeutic products for corneal cross-linking which have been FDA approved to treat progressive keratoconus. This approval offers an effective treatment for patients who, until recently, mostly required surgical solutions to treat their sight-threatening disease. Chico Eye Center is the only office that performs this procedure between Sacramento and Medford.
cross linking procedure example
Understanding Keratoconus
& The Importance of Early Diagnosis
understanding keratoconus pdf download

DMEK Overview

DSEK Overview

Pterygium - Surgery overview

Crosslinking Overview