Since I originally told my story in 1999, exciting things have been happening in the treatment options for Fuchs' corneal dystrophy.
Up until recently, only one type of transplant option was available: a full-thickness transplant referred to as a PK (penetrating keratoplasty).
About three years ago, a doctor named Mark Terry in Portland, Oregon, adapted a version of a transplant pioneered by a Dr. Melles in the Netherlands. This is a partial-thickness transplant that replaces only the diseased layer of the cornea, the corneal endothelium (innermost layer). Dr. Terry refers to this procedure as a DLEK (Deep Lamellar Endothelial Keratoplasty).
Dr. Terry began performing these transplants and was getting good results. The main advantages to this partial transplant are the shortened recovery time, the reduction in post-transplant astigmatism, and the resulting strength of the cornea which is close to the original integrity of the eye.
Dr. Terry has trained many doctors from around the world in this procedure and it has been avidly sought by patients with Fuchs. Another doctor, Francis Price, of Indianapolis, Indiana, also adapted the procedure developed by Melles and Terry and added a new idea that also came from Dr. Melles. This idea was to separate the patient's cornea at the Descemet's membrane layer. This additional variation on the DLEK technique requires less instrumentation and is being adopted by a number of surgeons in the U.S. who are being trained in Dr. Price's training program.
Both Dr. Terry and Dr. Price and their trainees are getting very good results from these new procedures. The resulting vision is usually a little less sharp that the vision that can be obtained through a PK plus glasses, but many patients are willing to have the vision be less sharp if the resulting astigmatism is less - and indeed it is. Dr. Terry has reported that most of his patients are actually able to use the same glasses they used prior to surgery. And, for many patients who have cataract surgery at the same time, glasses are not needed at all to attain useful vision.
The future is very bright for people who suffer from Fuchs corneal dystrophy. After 50 years of the same surgical techniques, surgeons are now pursuing and refining new techniques which they hope will provide better vision and improved healing for their patients.
Members of Fuchs Friends can take advantage of a wealth of information available on our members website. And, they can get the advice and support of our enormous community of people with Fuchs. At this writing, more than 300 people have had cornea transplants. Approximately 50 of those have had one of the new procedures.
All of our members are willing to share their stories with other members, making this group the broadest set of Fuchs experts on Earth.
Copyright Dorothy Acton and Signe Maximous
Jan. 23, 2005
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