Corneal disease
Corneal dystrophies and keratoconus
Call for an appointmentDuke corneal surgeons are experts in corneal transplantation to treat corneal disease including keratoconus and corneal dystrophies, including Fuchs’ dystrophy. We use the most sophisticated imaging technology to diagnose your condition, and offer ongoing medical management of corneal infection, corneal ulcers, dry eye and corneal scarring. If your condition has progressed to the point where you require a corneal transplant, we employ the latest surgical advances to repair your diseased corneas and improve your vision. Our goal is to return you to your normal daily routine as quickly as possible.
Corneal disease specialists
Corneal disease is a serious concern that can severely impact your vision if not treated promptly and effectively. Our corneal surgeons are ophthalmologists who have undergone advanced training in the medical and surgical management of corneal disease. Our surgical expertise, and access to the most technically advanced equipment, ensures you receive and accurate diagnosis and the most effective treatment plan. Our recommendations are based on the severity of your condition, and its potential impact on your vision.
You may be a candidate for corneal transplant if your cornea has been impacted by scarring, trauma, infection or disease, and is no longer capable of allowing normal visual function. The most common corneal diseases requiring transplantation are keratoconus, in which the cornea becomes thin and cone-shaped, and inherited corneal dystrophies such as Fuch’s dystrophy, in which the cornea's thin layer of endothelial cells no longer function properly. This can lead to corneal swelling. We have years of experience treating these and other corneal conditions, and perform hundreds of corneal transplants each year. Our skill in the latest corneal transplant advances ensures you recover your vision and return to your daily activities quickly.
Choose Duke for your corneal disease care because we offer:
- Leading eye care experts. U.S. News & World Report consistently ranks Duke Eye Center among the nation’s best.
- New advances in corneal transplant. Whenever possible, we use the latest techniques to remove only the diseased portion of the cornea, rather than all the layers of the cornea. These new techniques retain the structural integrity of the eye and minimize your risk of rejection. At the same time, you recover faster with the best possible vision.
- New approaches to diagnostic imaging. Our researchers are studying new ways to use optical coherence tomography (OCT), a non-invasive imaging technology that allows us to look closely at the cornea and assess corneal disease.
- Experience in artificial cornea placement. We are one of the few eye centers in the region with the surgical skill and expertise to treat advanced corneal disease with artificial cornea implants (keratoprothesis). This may be an option if you have had no success with standard corneal transplants.
- Compassionate, supportive environment. We offer patient support services, including educational materials and programs, a low vision rehabilitation program, and a dedicated social worker to help you and your loved ones manage your condition and maximize your quality of life.
- PATIENT STORY
Corneal transplant advances improve visionI trusted Dr. Gupta so I agreed to let her try this new approach. My recovery was quicker.
CORNEAL DISEASE
Treatments
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Antibiotics, antivirals, and antifungal may be prescribed if you have an infection caused by bacteria, virus or fungus.
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Vision-correcting hard contact lenses, known as scleral contact lenses, are custom-fitted to corneas that are irregularly shaped due to keratoconus or other causes.
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May be used following certain procedures to reduce the risk of corneal hazing.
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Small, circular, corneal rings called Intacs are surgically implanted in the eye to correct irregular-shaped corneas and improve vision impaired by keratoconus.
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Also referred to as penetrating keratoplasty or PK, this procedure restores vision by surgically removing all five layers of the diseased cornea, and replacing it with clear, healthy cornea tissue from a donor. May take up to one year for functional vision to return.
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An effective alternative to full thickness corneal transplant. Only certain layers of the cornea are replaced with donor tissue. Depending on the location of the diseased cornea tissue, your surgeon may use donor tissue to replace one or more layers of the cornea, including the endothelium (DMEK), the stroma and/or Descemet’s membrane (DSEK). Recovery is quicker than full thickness transplant, minimal to no sutures are required, and functional vision returns within days to weeks.
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During PTK, a laser beam removes corneal irregularities, scars and diseased tissue from the surface of the cornea. It can also be used to reshape the cornea to improve vision. Recuperation takes days, as new tissue grows over the corneal surface.
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Restores vision by removing the severely damaged or diseased cornea and replacing it with an acrylic artificial cornea and donor corneal tissue that is sutured in place. A soft contact lens is applied to the surface that must be worn at all times.
CORNEAL DISEASE
Tests
Your corneal surgeon will conduct a thorough examination of your eye and its structure using a variety of imaging devices.
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Magnified, 3-D examination of the structures at the front of the eye.
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A computer-guided device creates a 3-D image map of the cornea to measure corneal power, curvature, and thickness.
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Ultrasound waves measure the thickness of the cornea.
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Measures the curvature of the cornea’s front surface to assess astigmatism.