THE CENTER FOR CORNEAL DISEASES & DRY EYE

Our Dedication

Having a regional center dedicated to corneal diseases and dry eye is necessary due to the large growing number of seniors in Florida, Tampa Bay and, especially Pinellas County. We’ve developed this center just for the care of ocular surface diseases by combining talented physicians with specialized education and training in the most advanced procedures and medicines for the treatment of ocular surfaces diseases. Here, patients can seek world-class care by some of the most elite physicians in this field of study.

Our board-certified and fellowship-trained eye care specialists are able to diagnose and treat many ocular diseases within the comfort of The Eye Institute’s own surgery center, The Largo Ambulatory Surgery Center. Trained in some of the most esteemed medical universities in the United States, our physicians are able to treat corneal disease using the latest treatment techniques available with better results and faster recovery. Our physicians have developed new patented technology designed for better corneal outcomes. In our state-of-the-art facilities we help patients see and feel their best.

Corneal Transplant

For over a century, physicians have commonly performed a full thickness corneal transplant to correct vision loss from corneal diseases and disorders. Today, the DSAEK procedure is the most advanced transplant treatment option available and is performed by Dr. Neel R. Desai, a leading refractive expert who specializes in corneal diseases, cataract and LASIK procedures at The Eye Institute of West Florida. Currently he is one of 125 surgeons worldwide specifically trained in the DSAEK procedure and has performed thousands of these advanced vision recovery procedures.

How the Cornea Works

The cornea is the clear window at the front of the eye that bends and helps focus light onto the back of the eye (retina). In order for vision to be clear, the cornea must be clear. Corneal disease can cause the cornea to become opaque or cloudy, preventing light from passing through clearly. The human cornea is composed of five layers. The epithelial layer is the most superficial layer and lies on the second layer, Bowman’s membrane. The third layer, the stroma, is the thickest and makes up about 90% of the total corneal thickness. Descemet’s membrane is the fourth layer and provides support for the innermost layer, the corneal endothelium. The endothelial cells pump fluid out of the cornea which is necessary for the cornea to remain clear and thin and provide good vision for the eye. If the pump cells become dysfunctional, damaged or destroyed, the cornea becomes swollen and cloudy. This condition of the cornea causes blurry vision and pain.

Endothelial cells can be lost due to aging, inherited diseases (such as Fuch’s dystrophy), trauma or previous intraocular surgery. If a critical number of endothelial cells are lost, the cornea becomes swollen and cloudy. Severe cases require a corneal transplant.

CORNEAL DISEASES:

Dr. Neel Desai received training in some of the most prestigious medical facilities in the United States to bring world-class care to The Eye Institute of West Florida and Pinellas County. His unique experience in the most advanced procedures available afford him the needed skill to successfully treat many corneal diseases such as the following: Fuchs’ Dystrophy, Allergies, Conjunctivitis (Pink Eye), Corneal Infections, Dry Eye, Corneal Dystrophies, Herpes Zoster (Shingles), Iridocorneal Endothelial Syndrome, Keratoconus, Lattice Dystrophy, Map-Dot-Fingerprint Dystrophy, Ocular Herpes, and Pterygium.

“I was delighted and compelled to write my letter of appreciation to Dr. Stephen Weinstock for his leadership in providing quality eye care to thousands of people in West Florida by forming a large group practice and assembling some of the finest eye surgeons in the area…

 

I am extremely pleased with my experience at The Eye Institute and so is my wife Carol. We both want to thank Dr. Desai and your entire staff for the excellent care we have received at The Eye Institute of West Florida.”

 

- J. M., BDS, DDS, MSD, MS, FRSH
Diplomat of the American Board of Orthodontics

TREATMENT:

Penetrating Keratoplasty

A penetrating keratoplasty (PKP) is a full-thickness corneal transplant and was first developed over 100 years ago. In this procedure, donor tissue is transplanted to replace a patient’s central cornea. A corneal transplant is done for a variety of diseases or trauma that has resulted in poor vision from scarring of the cornea.

Traditional corneal transplant surgery has about a 90% success rate. Astigmatism after traditional corneal transplant surgery can be significant enough that eyeglasses alone won’t give adequate vision. These patients may ultimately require contact lenses or additional surgery to reduce or eliminate the astigmatism. Full visual recovery and wound healing can take over 12 months.

DSAEK

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A DSAEK procedure is a partial-thickness corneal transplant that replaces only the endothelial layer. A thin piece of donor tissue containing only the endothelial cell layer is inserted onto the back surface of the patient’s cornea. The surgery itself takes less time with an experienced surgeon, involves smaller surgical incisions requiring far fewer stitches, heals faster and more predictably, and the vision returns so much faster.

Sutureless Corneal Endothelial Transplant

There are several major advantages to the DSAEK operation compared to standard corneal transplant surgery. The smaller wound is more stable and less likely to break open from trauma. Because the wound is smaller and requires far fewer sutures, there is very little postoperative astigmatism so visual recovery is much faster. For optimal visual improvement following DSAEK only takes only about 3 to 4 months as opposed to months or even years with a full-thickness corneal transplant.

Am I A Candidate?

Only patients with Fuchs Dystrophy or endothelial cell problems are candidates for DSAEK. Patients with corneal scarring or other conditions affecting other layers of the cornea will still require the full-thickness procedure.

Surgical Procedures

The surgery is usually performed on an outpatient basis. The patient is sedated, and the eye is completely anesthetized. A small incision is made to allow the surgeon to strip away the diseased Descemet’s membrane and damaged endothelial cells. Next, the donor endothelial cells and Descemet’s membrane is inserted through the same incision. After it is placed in position, an air bubble is used to hold the transplant tissue in place.

For more information or a personal consultation with one of our refractive specialists, please call (727) 581-8706 for an appointment at one of our three convenient locations.

DRY EYE

What is Dry Eye Syndrome (DES)?

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Tears nourish and lubricate the front surface of your eye. Dry eyes are caused when the tear producing glands of the conjunctive do not produce enough tears or produce tears that do not have the proper balance of nutrients to keep the eye surface healthy. Dry Eye Syndrome is the most common of all eye disorders affecting approximately 20% of the population.

How Do I know If I have Dry Eye Disease?

• Dry Sensation
• Scratchy, Gritty Feeling
• Burning
• Stinging
• Itching
• Excessive Tearing (watery eyes)
• Mucus Discharge
• Irritation from Wind or Smoke
• Redness
• Tired Eyes
• Light Sensitivity
• Contact Lens Discomfort
• Contact Lens Solution Sensitivity
• Soreness

How is Dry Eye Diagnosed?

By using specialized stains, drops and instruments in combination with careful microscopic evaluation of the tear film, eye surface and eyelid margins, we are able to assess both the quantity and quality of tear film.

Predisposing Factors for Dry Eye Disease:

• Aging
• Menopause
• Allergies
• Environmental Stresses
  • Contact Lens Wear
  • Wind
  • Air Pollution
  • Low humidity: Heating/Air Conditioning
  • Lack of Sleep
  • Use of Computer Terminals
• Ocular Surgery (LASIK, Corneal Transplant)

What If I Don’t Get Treatment?

Chronic inflammation and irritation can lead to nerve damage, permanent blurred vision, corneal scaring and an increased risk of infection. When treated properly these complications of dry eye can usually be completely avoided.

Treatment

Treatment of dry eyes starts with an understanding of the chronic nature of the problem and the need to be consistent and proactive. Artificial tears, gels and ointments are the most common initial treatments for dry eyes. Eye drops lubricate the eyes, replace missing moisture and help rebalance the nutrients in the tear film.

Patients who need more help can also take steps to prevent tear evaporation. Using a humidifier to add moisture to the air and avoiding smoke, wind and other irritants can help. Also, the use of oral vitamin supplements that boost the oil layer of the tear film and reduce evaporation may provide relief.

Additionally, narrowing or blocking the tear ducts which drain tears and moisture from the eye, help keep the ocular surface from drying out. Tear flow regulators are inserted into the tear ducts in a simple, painless in-office procedure called punctual occlusion.

Choosing an Eye Specialist

Contact The Eye Institute of West Florida and make an appointment with our dry eye specialist, Neel R. Desai, M.D..  Allow us to treat your dry eyes to relieve the unnecessary discomfort or potential damage to your vision.

Neel R. Desai, M.D. is a fellowship-trained ophthalmologist strictly specializing in LASIK, cataract and corneal diseases of the eye. Dr. Desai is a top graduate of the Pennsylvania State University College of Medicine and completed his fellowship in cornea, cataract and refractive surgery at the Wilmer Eye Institute at Johns Hopkins University. He is recognized throughout the country and internationally as one of only 100 surgeons able to perform advanced corneal transplants and other complex cataract, corneal and refractive procedures. He holds pending patents to new surgical products and advanced cornea surgical procedures of his own design. Additionally, Dr. Desai has authored many book chapters in his field of study and continues to write articles in peer review journals.