Fuchs’ Dystrophy is a genetic condition of the cornea that leads to impaired, blurry and painful vision. The condition exists due to the inability of the last (inner) layer of the cornea to properly hydrate and nourish the cornea. The cornea has no vascular support and relies on this layer called endothelium to provide vital enrichment necessary for corneal health.
The standard method to correct this condition was to have the surgeon perform a PKP. A PKP is a surgical technique where the central portion of the cornea was removed and a donor piece of corneal tissue was stitched in place of the removed tissue. The healing time for this procedure was anywhere from 6 months to 1 year and because the tissue was stitched in place the need for glasses to correct astigmatism was assured. There also existed the possibility post surgery that a blow to the back of the head could cause the stitches that held the donor in place to rupture resulting in the eye going blind.
In 2003 Dr. Mark Gorovoy along with surgeons Dr. Francis Price and Dr. Mark Terry pioneered a procedure to enhance and make safer the replacement of the portion of cornea that was diseased. This procedure was eventually named DSAEK. Instead of taking the full thickness of the central portion of the cornea, the new procedure simply replaced the inner layers of the cornea leaving the outer portions intact. This reduced the need for astigmatic correcting glasses but more importantly since there were no stitches, the possibility for rupture and resulting blindness were eliminated. The healing time and return to significantly better vision was reduced to just a few weeks to a month. The other significant benefit to the patient with this new procedure was the ability to repeat the surgery as many times as necessary should the graft not take.
In 2012 the team of Doctors enhanced the DSAEK procedure further by implanting only the endothelial layer of the cornea. This new procedure is called DMEK and has improved visual outcomes over the DSAEK procedure. The demand on surgeon skill is great for the DMEK procedure and only a few corneal specialists have mastered it. Dr. Mark Gorovoy has performed over 1,500 DSAEK and DMEK procedures since 2005 with very positive post operative outcomes.