Corneal Care Center

What Is the Cornea?

The cornea is the clear, dome-shaped, outermost layer of the eye. It serves as a barrier against germs and dust, and also plays an essential role in our vision and ability to focus. If the cornea is damaged or diseased the vision can be affected. Corneal disease can range from the simple to the complex. In the event that you have a complex problem requiring advanced medical care or cornea surgery in Washington, DC or the surrounding areas, we are fortunate to have on staff two fellowship-trained corneal specialists, Dr. J. Alberto Martinez and Dr. Daniel Sarezky.

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Cornea Surgery in Washington D.C.

If you’re looking for trusted doctors for your cornea surgery in Washington, D.C. or Maryland, Visionary Eye Doctors has the medical professionals for you! J. Alberto Martinez, MD and Daniel Sarezky, MD have extensive experience in modern cornea transplant techniques and has performed hundreds of these procedures. Additionally, Dr. Martinez and Dr. Sarezky are one of the few physicians to offer Corneal Collagen Cross Linking which may prevent cornea transplant surgery for those with keratoconus. Dr. Sarezky completed his fellowship at the internationally renowned Wilmer Eye Institute at Johns Hopkins University. Dr. Martinez has presented on modern cornea transplant surgery at national meetings. Dr. Martinez has performed more than 12,000 pterygiectomies and corneal surgeries combined, with a pterygium recurrence rate of 0.06%. This impressive low recurrence rate has been studied and recognized internationally, positioning Dr. Martinez as a top cornea surgery doctor.

What are common symptoms of corneal disease?

Your cornea usually heals itself quickly after most minor injuries or infections. But during the healing process, you might experience symptoms like burning, pain, tearing, blurred vision, extreme sensitivity to light, foreign body sensation, and redness.

What are common corneal conditions?

As such a prominent, exposed part of the eye, the cornea is vulnerable to a host of problems. There are various conditions that can affect the cornea and require treatment. Here is a partial list of the conditions we treat:

Dry Eye Syndrome
Corneal abrasions
Corneal ulcers
Corneal scarring
Corneal infections
Keratoconus
Fuchs’ dystrophy
Inflammations of the cornea
Pterygium
Injuries to the cornea from trauma
Pediatric corneal diseases

There are many conditions that can affect the clarity of the entire cornea. Sometimes corneal failure can also occur after an eye surgery, such as cataract surgery. Research done in our office shows the benefits of Pentacam® Scheimpflug Camera Technology to determine severity of corneal diseases and aid the treatment strategy.

What Are the Treatments for Corneal Disease?

Most corneal conditions can be treated medically with eye drops, ointments, pills, contact lenses, amniotic membranes, etc. On occasion, office procedures or cornea surgery may be recommended to help improve your symptoms. Office procedures may include the insertion of punctal plugs for dry eye or removal of foreign bodies. Surgeries and procedures can include pterygium removal, corneal collagen cross linking and corneal transplantation.

At Visionary Eye Doctors we offer an array of cornea surgery procedures in Washington, DC, in our office-based surgery suite and at a state-of-the-art surgery center to treat different diseases and conditions, such as:

Corneal Collagen Cross Linking
Cornea transplant
Anterior segment reconstruction
Limbal stem cell transplant
Lens implant exchange
Intacs
Amniotic membrane transplantation (AMT)
Pterygium surgery
Pinguecula removal
Lamellar keratectomy
Corneal tattooing

At Visionary Eye Doctors, our specialists perform traditional, full-thickness corneal transplants (penetrating keratoplasty), as well as corneal grafts that involve replacing only part of the cornea. Thanks to innovative technology and scientific advances, this common procedure is not as daunting as many people might think.

At Visionary Eye Doctors, we offer the following options for corneal transplant:

PKP: Penetrating keratoplasty is often referred to as traditional corneal transplant surgery because it replaces the full thickness of the cornea. During the procedure, a “button” of tissue is removed from the diseased or injured cornea using either a surgical cutting instrument called a trephine or a femtosecond laser. A matching “button” from the donor tissue is then positioned and sutured into place. The sutures, which are finer than a human hair, are left in place for several months to a year or more after surgery.

DSAEK: Descemet’s stripping and automated endothelial keratoplasty replaces only the damaged endothelium – the innermost layers of cells within the cornea – while leaving the healthy parts intact. This allows our surgeons to use a much smaller incision, reducing recovery times and risks as compared to a traditional corneal transplant.

DMEK: Descemet’s membrane endothelial keratoplasty (DMEK) is a partial-thickness corneal graft operation in which only Descemet’s membrane and endothelium are replaced. DMEK is the most advanced form of partial corneal transplant procedure indicated in diseases affecting the innermost, endothelial layer of the cornea. In DMEK surgery, only a single thin layer of cells is replaced, allowing for an exact anatomical replacement of the damaged cells. This technique allows for decreased rates of rejection and faster visual recovery. The other benefit of DMEK is better potential vision (more patients seeing 20/20).

Alternative to Corneal Transplant: PTK

Some corneal conditions, such as certain dystrophies, scars, and infections, are eligible for treatment with phototherapeutic keratectomy (PTK). This is an innovative alternative to corneal transplant for carefully selected patients. PTK utilizes a computer-guided excimer laser to precisely vaporize layers of damaged or diseased corneal tissue, effectively removing the surface irregularities.

Intacs® Corneal Implants for Keratoconus

The purpose of the Intacs® procedure is to flatten out the cone-like shape in the patient’s cornea, enabling them to achieve clearer vision when wearing glasses or comfortably wear contact lenses. This choice is utilized for those patients who are unable to tolerate contact lenses and as a step in preventing or delaying a corneal transplant. Intacs are also a less invasive option for a patient with keratoconus.

Keratoconus is a corneal disease that creates a thinning of the tissue. As the outermost layers of the eye get thinned, normal pressure within the eye causes the tissue to slowly bulge forward into a cone-like shape. This steepening causes a decrease in vision. As this process progresses the vision may further deteriorate. Keratoconus rarely leads to blindness; however, it may cause daily activities to be harder to perform. The cause of keratoconus is unknown, however it is believed to be genetically acquired and environmental factors such as allergens and the rubbing of the eyes may exacerbate the situation. In most cases, the changes in the cornea due to keratoconus begin in the teen years and stabilize at about 30 years of age. Patients are almost always left highly nearsighted with astigmatism.

How do the Intacs work?

The purpose of this procedure is to improve vision and to allow patients to more comfortably wear contacts or glasses. The implants, which look like a letter C, reshape the tissue to add support to the thinning area, thus preventing or decreasing the bulging of the cornea. With the implants in position, a more normal surface of the eye is created allowing the patient to have better vision and an easier fit for contacts.

Imagine your cornea as a tent with a curved top. If you push out the sides of the tent, the top flattens. Similarly, when Intacs corneal implants are placed in the sides of the cornea, they flatten it just enough to correct myopia.

Request a Surgical Consultation

The first step in determining your candidacy for your cornea surgery in Washington, DC or the surrounding areas is to schedule a consultation and experience our comprehensive eye exam. This is the most complete eye exam available today and includes a consultation with one of our experienced surgeons. Utilizing advanced diagnostic technology, our surgeons will not only evaluate your candidacy for a procedure for but will look at the overall health of your eyes and establish a long term plan for your best vision.

Please help us provide you with the best experience by answering a few quick questions, and one of our surgical counselors will assist you. If you are a current patient and/or have a medical concern or question, please contact us directly at 301.896.0890.