When your eyes fail you
By Jeanne Millsap For The Herald-News February 7, 2012 9:34PM
A cornea condition called Fuch’s dystrophy can cause excess eye watering and blurry vision. The condition can be corrected with surgery to replace the layer of the cornea that is affected.
Updated: March 9, 2012 8:06AM
Kenneth Woodrum, of Braidwood, knew something was going on when his right eye began tearing up.
“It just kept watering and watering,” he said, “and that made my vision blurry in my right eye.”
Woodrum travels quite a bit with his job and also noticed his night vision was not what it used to be. What he didn’t know was that his cornea had basically shut down and was filling with fluid, causing the blurry vision and tearing.
Silver Cross ophthalmologist Dr. Timothy Kisla knew pretty quickly what the diagnosis was. He has seen it before. Woodrum had Fuch’s dystrophy, which is a slowly progressing disease of the cornea. The cornea is the outermost layer of the eye, but it serves as more than just a protective layer. Along with the lens, it focuses the light to the retina, and it has also has a fluid-regulation feature.
There are five layers to the cornea, and the innermost layer —the endothelium—allows fluid to seep inside the cornea to nourish the other layers. It also pumps fluid out of the cornea. When its pumping mechanism fails, as in Fuch’s dystrophy, there can be a buildup of fluid in the cornea, leading to excess eye watering and blurry vision.
Kisla recommended Woodrum have a special kind of cornea transplant to treat his dystrophy. It’s called DSEK, or descemet’s stripping endothelial keratoplasty, where only one single layer of the cornea — the innermost endothelial layer — is removed. A replacement layer is transplanted. The procedure is so new that Kisla has only been doing it for two years.
“We only have to make two very small incisions,” Kisla said of the surgery. “A single layer of cells is removed in one sheet … and the donor tissue is inserted through the small incision.”
The thickness of the entire cornea is only one-twentieth of an inch thick, Kisla explained, and the endothelial layer is even thinner. That layer is used throughout life, but sometimes trauma or a disease like Fuch’s damages it.
Before DSEK, Tisla said, the entire cornea would have to be transplanted even though only one of the five layers was bad. The surgery was longer, more stitches were used, recovery was longer and the chance of rejection was greater.
“My vision is almost 20-20 now,” Woodrum said, one year after having the surgery. “I progressed pretty fast.”
Woodrum said he has been able to return to driving at night for his job with no problems.