DSAEK Cornea Transplant Questions
Is the LASIK procedure painful?
No. Several anesthetic numbing drops are given prior to the procedure to eliminate pain and discomfort. As well as 5mg of valium to help you relax and to help you sleep once you return home following the procedure.
What about after surgery?
With LASIK, there is virtually no pain. You may have the sensation of having a tiny spec of something in the eyes, like a dried contact lens for twelve to twenty-four hours. With PRK there can be slight discomfort lasting for several days. A bandage soft contact lens is applied to reduce discomfort and an analgesic eye drop is given, if needed, for pain. Pain medications are typically prescribed for the PRK procedure.
How long will it take to recover from LASIK and/or PRK?
With LASIK, it takes most patients less than twenty-four hours to gain functional visual recovery and return to work. Nearly all LASIK patients report being able to see better immediately after surgery. PRK requires five to seven days of recovery with the bandage contact lens, and the patient will experience gradual improvement in vision over the first few weeks.
What are the risks or possible complications?
Patients do not have poor night vision with the WaveLight® Allegretto Wave® Eye-Q Laser System. Surgery may result in under correction or overcorrection, which can often be improved with a refinement surgery. More rare and serious complications include a dislocated flap, epithelial ingrowth and inflammation underneath the flap. Most complications can be managed without any loss of vision. Permanent vision loss is very rare.
Could I do something to ruin the results?
Blinking of the eye is prevented by an eyelid speculum that holds the eye open, so the patient can focus on a red blinking light in the microscope for part of the treatment. Throughout the procedure, the physician is observing proper alignment using the microscope. In case of slightest misalignment, the procedure is paused and alignment is corrected prior to the procedure continuing.
Does insurance cover the LASIK or PRK procedures?
In most cases, insurance does not cover the LASIK or PRK procedure. You should expect to pay for your procedure in full at the time of surgery. Any reimbursement by the insurance company will be made directly to you. Excellent financing options are available through CareCredit, such as 24 months with no interest financing, or up to 60 months with interest. Please see our financing page for the link to CareCredit’s website.
When can I see clearly?
Your vision is usually dramatically improved within the first twenty-four hours. It is normal for vision to fluctuate from day to day, especially for the first couple of weeks. How quickly your vision clears, depends on the severity of your original prescription. Normally it takes six to eight weeks for your vision to stabilize completely. Most patients are reading the 20/20 line or better on their 1 day post-operative appointment.
Can’t I just wear glasses or contact lenses?
Sure. However, LASIK gives you a lifestyle that no pair of glasses or contacts ever could. Your vision, many times, is better than perfect. We’re talking 20/15 vision in most cases. Of course, predicting the outcome of any treatment can vary from person to person. Dr. Goosey will provide you with information on what type of results you can reasonably expect.
The best glasses or contacts can never dream of supplying you with this type of perfect vision. Visual aid instruments do not alter your vision, so you can never say you have “perfect” vision. On top of that, glasses and contacts hinder you from taking part in outdoor activities the way you want to. Golfing, swimming, hunting, rock climbing, and tennis, or practically any outdoor event is harder to do with glasses or contacts.
How fast is the recovery?
In one to two days after the procedure, your entire life will be lived without restriction or limitation due to vision. The fact is, even during the day or two of recovery, your life is barely infringed upon. Other than the perfect vision, most patients can hardly tell they had surgery the next day.
What if it doesn’t work like I expect?
In the early years of LASIK, attaining the desired result meant trudging back and forth to the surgeon for “enhancement” procedures. An “enhancement” is simply when the doctor uses his LASIK equipment to adjust the treatment a bit. However, now with the advent of modern technology, this rarely is the case. Typically, one visit to the doctor for one procedure is all that is necessary to have clear and natural perfect vision.
What technology does Dr. Goosey use when performing the LASIK procedure?
There are many different types of lasers and equipment used when a LASIK procedure is performed. Dr. Goosey uses the WaveLight® Allegretto Wave® Eye-Q Laser, and the WaveLight® FS-200 Femtosecond Laser System from Alcon.
Is there more than one procedure for vision correction?
Today there are many techniques to correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. For most patients, Dr. Goosey prefers the technique commonly known as LASIK (Laser-Assisted in Situ Keratomileusis) and he is an expert. LASIK is the fastest growing procedure in ophthalmology, and in many cases, eliminates or diminishes the need to wear eyeglasses or contact lens.
This procedure surgically alters and corrects the shape of the cornea to correct refractive errors. In order for the eye to focus light clearly on the retina, the cornea (outer window of the eye), must be of the proper curvature. Using a “cool” light beam from the WaveLight® Allegretto Wave® Eye-Q Laser, very minute quantities of corneal issue are removed, predictably altering the shape of the cornea, and in turn, correcting the refractive error.
Where is Dr. Goosey?
Dr. Goosey is located in the Houston Eye Associates building at 2855 Gramercy St; and he serves the entire Houston metro area including Bellaire, Galena Park, Jacinto City, Meyerland, Missouri City, Pasadena, Pearland, River Oaks, Sharpstown, Spring Branch, Stafford, Sugar Land, Cypress, Champions, Tomball, The Heights, as well as the Medical Center and West University Place.
Where are the LASIK and PRK procedures performed?
Both LASIK and PRK are performed in our Lasik Suite, located on the third floor of the Gramercy building.
Where is the DSAEK procedure performed?
DSAEK corneal transplantation is performed in an outpatient surgery center. No hospitalization is required.
How long does the procedure last?
The total time the patient will be in the surgery center is approximately 2 to 2.5 hours. Once the patient is taken to the operating room, the procedure is completed in 20 to 30 minutes. Additional time may be necessary if other procedures are also planned, like cataract surgery or intraocular lens replacement. After the procedure is completed the patient is taken to the recovery room where they must lie on their back for 45 to 60 minutes. This allows the air that has been placed in the anterior chamber of their eye to affix the transplant into position.
When will I need to return for a follow up office visit?
The first office visit is scheduled about 1.5 to 2 hours after the DSAEK procedure has been completed. After leaving the surgery center you will be taken to my office. The visit is necessary so that I can remove the air that was placed in your eye. Since your eye is still totally numb you will not experience any pain while I remove the air. Removal of the air only takes a few seconds and is necessary so that you do not experience an intraocular pressure spike during your first post-operative evening. Removal of all the air is not required and some air usually remains in the eye to help maintain the transplant in proper position. You will also return for a follow-up visit the next morning after DSAEK surgery. During this visit, the health and position of the new transplant will be checked. If everything is in proper order you will start your post-op eye drops as directed and return for a follow-up visit in 1-2 weeks.
What types of drops will I need after the surgery?
You will continue using the antibiotic eye drops (Besivance) that you started three days prior to surgery. Use the Besivance 4x per day for one week after surgery unless otherwise instructed. You will also use a steroid eye drop (Omnipred 1% or Pred Forte) 4x per day until otherwise instructed. The steroid drops are required to prevent rejection of your new transplant. If you are also using glaucoma eye drops, continue to use them after surgery unless otherwise instructed.
When will I see improvement in my vision?
Visual recovery varies depending on the severity of your corneal cloudiness prior to surgery. Most patients notice improvement in their vision during the first two weeks after surgery, with continued improvement during the next four to six weeks. This recovery represents a dramatic improvement over the time required following conventional corneal transplant surgery (PKP), which usually takes six to twelve months. Some DSAEK patients may not notice visual improvement as quickly as they would like, because they have other ocular conditions such as a cataract or retinal problems that must be addressed.
Can my DSAEK transplant undergo rejection?
Although the rate of rejection with DSAEK does not appear to be any higher than rejection rates with PKP, endothelial rejection can occur following DSAEK. The signs and symptoms of such rejection episodes are the same as they are for PKP patients. Briefly, if you experience redness, photophobia, and blurred vision assume that you are having a rejection episode, and call my office so that you can be evaluated immediately. Most rejection episodes are successfully terminated by using steroid eye drops. The sooner a rejection is treated, the better chance for transplant survival.