These layers of the cornea work together to allow light the ability to travel through the eye for sight. Like the lens of the eye, the cornea works to capture the light. Therefore, the cornea is one of the most important components of the eye for providing sight.
This transparency is due to the endothelium part of the eye producing water. So how exactly does a corneal edema happen? A corneal edema occurs when there is a buildup of fluid in the eye. If you notice that your vision is hazy when you wake up, but gets better as the day goes on, this may be an indication of edema. The cornea is made up of layers, and one layer, the endothelium, helps remove fluid that collects within the cornea.
Endothelial cells do not regenerate, so if they become damaged there is permanent endothelial cell loss. While corneal edema after cataract surgery is becoming less common due to advancements in surgical technology, when it does occur from cataract surgery, it is called pseudophakic corneal edema or pseudophakic bullous keratopathy.
Certain drugs can increase the risk of corneal edema. Since the endothelial cells do not regenerate, the treatment for corneal edema is to replace the damaged cells.
However, for mild corneal edema salt water eye drops Muro can be used three to four times a day to reduce the swelling. Muro does not address the underlying problem of damaged endothelial cells but can be helpful for people with very mild corneal edema. A partial thickness cornea transplant is performed to replace the damaged cells and is curative for corneal edema. These are outpatient procedures performed with local anesthetic and IV sedation. A small incision is made near the edge of your cornea.
A gas bubble is put under the graft tissue to hold it in place, and the incision is sutured. The graft is monitored, and if necessary, a second bubble may need to be inserted to keep the graft in place until it bonds properly. After the graft heals, the patient can be fitted with glasses or contact lenses in a few months after the surgery. The new corneal tissue is held in place with sutures. Because the graft may be irregularly shaped, after this surgery you might need to wear corrective lenses to see clearly.
Risks from this surgery include damage to the lens of the eye, bleeding, glaucoma, or rejection of the graft. This procedure replaces only the damaged endothelial layer of your cornea, leaving the rest intact.
Both the procedure and the recovery are faster than with PK. Mild corneal edema might not cause any symptoms or require treatment. If you have surgery to replace your entire cornea, it could take a year or longer to get your vision back fully. Because the new cornea could be irregularly shaped, you may need to wear glasses to achieve clear vision.
The outlook depends on the cause of corneal edema. Mild edema might progress very slowly, so you may not notice any symptoms for a period of years — or even decades. For more severe edema, having surgery and wearing glasses or contact lenses can restore much of the vision you lost.
A cataract is a dense, cloudy area that forms in the lens of the eye. It develops slowly and eventually interferes with your vision. Fuchs' dystrophy can cause your vision to decrease over time. Unlike other types of dystrophy, this type affects both of your eyes. Mild cases of corneal edema may not require treatment, though your eye doctor may prescribe eye drops to help reduce swelling. Some doctors might also recommend using a hair dryer to blow air over your eyes, as it may help increase tear evaporation and reduce swelling.
If your condition is severe enough to interfere with your vision, your eye doctor may recommend a surgical procedure to replace the cornea via a corneal transplant keratoplasty.
During a corneal transplant procedure , an eye surgeon removes the central corneal tissue and replaces it with replicated, healthy tissue from a donor.
In DSEK surgery , the surgeon only removes and replaces the flawed endothelial layer of the cornea. The procedure and the recovery time are shorter with DSEK than with a full corneal transplant. You will also be given steroid eye drops as part of your treatment following a DSEK surgery. In addition, be sure to have a comprehensive eye exam annually to ensure your vision is clear, and your eyes are healthy and well-functioning. Regular eye exams are the most effective way to pinpoint any problems that could impact your vision in the short-term and long-term.
Corneal edema. Accessed June Corneal edema: Causes, symptoms, treatment. Dean McGee Eye Institute.
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