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Cornea Therapy and Surgery

Think of a healthy cornea as a thin, crystal clear window through which you see the inside of the eye. While other eye doctors specialize in treating the eye’s inside parts, corneal specialists look at the window itself to determine if it is interfering with a patient’s vision. Our corneal disease specialist in Durango, CO, Linda Rose, M.D., PhD, is a board-certified ophthalmologist and the only fellowship-trained corneal specialist in the Four Corners region. She offers 15 years of experience working with some of the most complicated and challenging cornea cases.

Dr. Rose completed a cornea fellowship in 2006 and served as the Director of Cornea Services at The University of New Mexico Health Sciences Center before coming to Four Corners Eye Clinic as the first cornea specialist in the region.

Her arrival meant that patients who once had to travel to New Mexico for advanced cornea surgery to repair damaged or diseased corneas can now have the procedures performed in Durango. This accessibility is especially important for patients undergoing complicated surgical procedures such as corneal transplants that affect the front part of the eye.

What Is the Cornea?

The cornea protects the eye from dirt, germs, and other things that can cause damage, and it filters some of the sun’s ultraviolet light. Its key role, though, is refracting light as it enters your eye. This refraction is essential for vision, which can be impaired if the cornea is damaged by disease, an injury, or infection.

The cornea is made up of the following 5 distinct layers:

• Epithelium: The cornea’s outer layer that prevents foreign matter from entering the eye. Additionally, the epithelium absorbs nutrients and oxygen from tears.
• Bowman’s layer: An extremely thin and dense layer of collagen tissue that makes up the transition between the corneal epithelium and the underlying stroma.
• Stroma: This is the cornea’s thickest layer and the part of the cornea that is reshaped by refractive surgery, such as LASIK. It consists of water and collagen, which allows for the transparency and shape of the cornea.
• Descemet’s membrane: Separating the stroma from the underlying endothelial layer of the cornea, this layer gradually thickens as you get older.
• Endothelium: a single layer of cells at the back of the cornea that pumps fluid from the stroma to keep your vision from getting blurry or hazy.

What Are Common Corneal Diseases?

There are a wide range of diseases and conditions that can affect the cornea—and your vision. In general, corneal disease clouds or distorts vision and, if left untreated, can eventually cause blindness. Some of the more common corneal conditions seen and managed by Dr Rose in our cornea clinic include:

• Infections of the cornea: bacterial, viral (including Herpes and Shingles), and fungal.
• Recurrent erosions of the cornea
• Keratoconus, including evolutions and referrals for Crosslinking of the cornea.
• Fuchs Dystrophy
• Corneal edema (or swelling)
• Neuropathic or chronic pain of the cornea
• Contact Lens Overwear
• Keratitis, scleritis, and Chronic Inflammatory conditions of the ocular surface (often associated with autoimmune disorders such as Rheumatoid Arthritis)
• Asthenopia related to dry eye and ocular surface diseases
• Trauma to the cornea and ocular surface
• Nerve palsies from stroke, trauma, or surgery that cause corneal disease and scar
• Complex ocular surfaces caused by a combination of problems such as allergic conjunctivitis, dry eye, and autoimmune disorders
• Pharmacologic (non-surgical) treatment of Ocular surface tumors
• Other corneal conditions including but not limited to band keratopathy and Salzmann’s nodules.

What Are the Treatments for Corneal Disease?

The appropriate treatment for corneal disease depends on the specific condition and its severity. Dr. Rose extensively trained under the supervision of some of the world’s leading cornea specialists and has performed more than 1,000 corneal surgeries.

Clinical Procedures

Some of the clinical procedures offered in our cornea clinic include:

• Lipiflow
• Amniotic membranes
• Bandage contact lenses
• Bo-tox
• Punctal plugs

Surgical Techniques

Some of the surgical techniques Dr. Rose performs include:

Endothelial keratoplasty or “partial corneal transplant”: This procedure is performed for patients diagnosed with Fuchs’ dystrophy and other conditions causing corneal edema (swelling of the cornea). Dr. Rose completed specialized training at the renowned Devers Eye Institute, mastering the most modern and advanced partial transplant technique known as DMEK. Dr. Rose is the only surgeon in the Four Corners region who performs this surgery.

Traditional corneal transplantation (penetrating keratoplasty): Called an “open sky” procedure, this surgery involves a complete transplant of a damaged or diseased cornea with a donor cornea. This procedure is also called full-thickness corneal transplantation, and Dr. Rose uses it in certain complex cases.

Pterygium surgery: This procedure removes non-cancerous growths when they don’t respond to eye drops. This outpatient procedure uses topical and local anesthetics and typically takes 30 to 40 minutes. Dr. Rose traveled to The Australian Pterygium Center in 2010 to learn an advanced surgical technique from its innovator. Additionally, she served as faculty on the American Academy of Ophthalmology’s Pterygium Surgical course from 2010-2015.

Keratoprosthesis or “artificial cornea.”

Surgical treatment of ocular surface tumors on the cornea and conjunctiva.

Ocular surface biopsies for non-malignant diseases, such as pemphigoid, and ocular surface reconstructions.

Surgical amniotic membrane grafts.

Removal of nodules (Salzmann’s Degeneration) and calcium deposits (Band Keratopathy) on the cornea.

Cornea Treatment FAQ

Is corneal surgery painful?

Patients typically do not experience pain after surgery, although initial discomfort is expected due to swelling.

How long does it take to recover from cornea surgery?

Patients typically are ready to return to nonstrenuous jobs and activities 1 to 2 weeks after a corneal transplant. Full recovery can take a year to 18 months, depending on the type of transplant you have.

How long will my vision be blurry after a cornea transplant?

The eye will need time to adjust to the new cornea. It can take a year to know how clearly you will be able to see. Once healing is complete, you may need to wear glasses or a contact lens for optimal vision.

Is there anything I should avoid after surgery?

For approximately 3 to 4 weeks after surgery (or as directed by your doctor):

• Avoid rubbing your eye even if it feels irritated or itchy.
• Do not wear eye makeup.
• Hold off on strenuous activities such as heavy lifting.
• Stay out of swimming pools, hot tubs, and dusty environments.

We will provide you with specific post-op instructions to follow after your cornea surgery.

Are you caring for someone with corneal disease? Visit our Eye Care for Your Loved One page.

If you’re concerned about corneal damage or disease, contact Four Corners Eye Clinic to request an appointment using the online form or call our office at (970) 259-2202 to schedule a visit with Dr. Rose or one of our other eye doctors. We have locations in Durango, Cortez, and Pagosa Springs, CO.

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