Our practice specializes in surgery of the cornea, which includes LASIK and other forms of refractive surgery. The cornea is the clear, thin tissue at the front of the eye. It functions much like a "window" through which light passes on its way to the retina. In addition to allowing light to pass, the cornea also "refracts" or focuses light. In fact, it possesses three times more focusing power than the natural lens inside the eye. This is the reason corneal surgery can be such a powerful "refractive" procedure to correct nearsightedness, farsightedness, and astigmatism.

There are major and minor corneal surgeries. Major corneal operations include cornea transplantation and LASIK. Minor operations include pterygium removal and superficial keratectomy. There are many other types of surgery as well. Corneal transplants require a specialist with additional training in this area. Dr. J. Grant Tew is a fellowship-trained corneal specialist. Dr. Tew completed a fellowship in cornea and external disease at Doheny Eye Institute at USC. He is qualified to provide consultations and treat a wide variety of corneal problems, including corneal transplants.

Corneal transplantation requires a corneal donor. The donated corneal tissue comes from a recently deceased individual. Most people can donate their organs at their death and can specify this desire on their driver's license. Upon death, the corneal tissue is kept healthy by closing the eyelids to prevent drying and placing ice packs over the eyes. A trained technician carefully removes the tissue and transports it to a local eye bank where the corneal tissue is thoroughly tested, processed, and preserved. The surgeon is notified once the tissue is approved. If the surgeon elects to use the tissue for his patient, the corneal tissue is sent via courier to the surgical facility. Corneal tissue can generally be successfully stored at 4 degrees Centigrade for up to a week before being utilized for transplantation.

A corneal transplant is performed for various pathologic conditions of the cornea, such as pseudophakic bullous keratopathy (clouding of the cornea after cataract surgery), keratoconus (a malformation of the cornea), and scarring of the cornea due to trauma or infection, and other problems. It is usually an outpatient procedure and performed with local anesthesia. The diseased portion of the patient's cornea is removed and replaced with the new, healthy donor cornea. Fine nylon sutures are carefully placed to keep the cornea in position and allow for healing. Healing of the corneal edges may take one to two years because of the lack of blood vessels in this tissue. The advantage of this avascular tissue is a dramatically decreased rate of rejection. Cornea transplantation is probably the most successful transplant operation performed, partly because of this low rate of rejection. It is estimated that over 30,000 cornea transplant operations were performed in the USA last year.