Barnet Dulaney Perkins Eye Center Practice Blog

Barnet Dulaney Perkin Eye Center’s very own Dr. Jordan Graff co-authored an article that was published in Retina, The Journal of Retinal and Vitreous Diseases. Click here to read the full publication

As a surgeon who has the privilege of helping restore vision by performing corneal transplants, this makes March an important month for me. I would not be able to have this privilege, nor would my patients have the fortune of seeing better, without the kindness of eye donors and their families. There are more than 42,000 corneal transplants performed every year in the U.S. Almost half of these transplants are used for partial thickness transplants or endothelial keratoplasty (EK). The Donor Network of Arizona provided 1227 corneas for transplantation in 2011. Corneal disease is the fourth most common cause of visual impairment worldwide in 2002 according to the WHO (world health organization).



How does the cornea affect your vision?


The cornea is the first structure light passes through as it enters your eye. You can think of it as a transparent dome that vaults iris, the tissue inside your eye that gives the eye its color. If you look at your watch it would correspond to the watch glass and the iris to the face of the watch. If the watch glass becomes scratched or opaque you will not be able to see the face of your watch as well. Similarly, if your cornea becomes cloudy, you will not be able to see as well.
The effect of a cloudy cornea can be similar to a cataract.



What are the reasons for a cloudy or distorted cornea?


Factors that affect the cornea are varied. They range from an infection of the cornea (corneal ulcer) to inherited diseases. These include corneal dystrophies, which lead to cloudy corneas over time and thinning diseases such as keratoconus, which lead to a distortion of the cornea. Fuchs’ corneal dystrophy or endothelial dystrophy as well as endothelial damage can lead to corneal swelling and cloudiness over time. This is because the endothelium, a layer of cells on the backside of the cornea, prevents swelling by pumping fluid out of the cornea. Fuchs’ dystrophy causes these cells to slowly deteriorate and decrease in number. When you don’t have enough of theses cells, fluid builds up in your cornea leading to swelling.



One of the treatments for the above mentioned conditions is a corneal transplant. The first successful corneal transplant was performed in 1906. Over the last 100 years we have experienced improvements in preservation and surgical techniques. In addition to the full thickness transplant we are now able to selectively replace the parts of the cornea that are not functioning properly. For Fuchs’
endothelial dystrophy as well as for corneal edema only the thin layers of cells/pumps (endothelium) is replaced. This procedure is called DSAEK. In cases where the endothelium is still healthy only the anterior parts of the cornea can be replaced, a procedure called DALK.
The same LASER used to create the flap during LASIK procedures can now be used to shape the interface between the patient’s and the donor’s cornea creating a better and more secure fit. These LASER created wounds can be compared to dovetailed joints interlocking in a much more secure fashion.



As the cornea specialist at Barnet Dulaney Perkins I am excited to be able to offer all of these options to patients who need a corneal transplant. Consider helping these patients as well.  Consider becoming an eye donor and discuss it with your family. You too can help restore another’s sight.

Robert Fintelmann, MD
Cornea, Vision Correction and Cataract Surgeon

What you may be experiencing is “Meibomian Gland Obstruction”, an underlying cause of Evaporative Dry Eye.

Your tears are made of 3 layers:

1. Lipid (oil) layer: lubricates and prevents evaporation

2. Aqueous (water) layer: nourishes and protects the cornea

3. Mucin layer: adheres tears to the eye

Meibomian glands: create the lipid (oil) layer of the tear film　

Warm compresses become a regular ritual, sometimes several times a day. A bottle of some form of eye drops is never far out of reach. Blinking exercises might be on the agenda, or maybe lid scrubs.

Contact lenses can only be worn for a limited time, if at all. Extended sessions in front of a computer are off limits. Relaxing with a good book may be too painful to contemplate. Even just deciding on the spur of the moment to go outside and enjoy a nice spring day could be out of the question.

Does any of this sound familiar?
If so, you need to know about the LipiFlow system, a technological breakthrough that has been developed to potentially make the discomfort, inconvenience and limitations of Evaporative Dry Eye a thing of the past.

The LipiFlow Thermal Pulsation System is a significant technological shift in evaporative dry eye treatment, effectively relieving blockage of the eyelid glands during an in-office treatment. Opening the blocked eyelid glands allows the body to resume the natural production of lipids (oils) needed for the tear film. Treatments last up to 1 year!

Imagine: Just a short time after a successful treatment with the LipiFlow system, you may go long periods of time without thinking about your eyes at all, just like most people do. You may no longer have to plan your day around your symptoms. Coworkers may no longer stop and ask you why your eyes are red or have you been crying.

After a few weeks, you may even start to forget about how much the condition was controlling your life. The constant drops, the warm compresses, the limits on how long you could sit at the computer or wear your contacts. Months later, you may no longer worry about the faintest breeze.

You can live your life again.

Arizona Republic, Living Well

Andrew Rabinowitz, MD, fellowship trained glaucoma specialist at Barnet Dulaney Perkins Eye Center, discusses the facts on Glaucoma in an article published today in the Arizona Republic (Living Well). For more information, read the attached article, it may just save your vision.

Andrew Rabinowtiz, MD

To find out more about Glaucoma visit www.goodeyes.com

We understand the decision to have LASIK or ICL can be difficult. Our goal is to help you make an informed decision and find the best solution to improve your specific vision needs. If you have been considering LASIK or ICL Implantable Contact lenses and have a few questions, log onto www.goodeyes.com and click on LASIK or ICL, you will see our LIVE CHAT button. Our patient counselors are standing by to help answer your questions.

At Barnet Dulaney Perkins Eye Center, we want to make the booking of an appointment process as easy as possible for our patients. With that in mind, we now have Online Scheduling available on our website. Online Scheduling is a fast, easy, convenient, and private way to schedule your appointments, complete your registration paperwork prior to your appointment, and even pay your bill. Once you create an account with our practice via the online form, you are all set to start scheduling in a secure process that can be utilized 24 hours a day. No more being placed on hold, and no more having to share your personal information with the reception staff. It’s just another way our team strives to make your experience with us convenient and as hassle-free as possible.