IntraLase Enabled Keratoplasty – Modesto, Stockton, Merced, Manteca, Tracy

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IntraLase Enabled Keratoplasty (IEK)

IntraLase Enabled Keratoplasty is a new technique in Laser Corneal Transplant surgery. Dr. Ash is the first surgeon in Northern California to perform IEK.

IntraLase Enabled Keratoplasty (IEK) is a revolutionary way of performing laser assisted corneal transplant surgery. It is the marriage of refractive surgery and cornea surgery. The precision of Laser instruments in Laser vision correction are employed to reduce manual imperfections of standard corneal transplant surgery.

Corneal Transplant surgery has been successfully performed for the past 100+ years. Very minor modifications have been made since. In the most basic terms, a trephine removes the cornea of the patient and replaces it with that of a donor. Much like a cookie cutter, one is cut out and then replaced and sewn into place.

DLEK and DSEK/DSAEK

With advancement in techniques and knowledge, there are certain conditions where only a specific portion of the cornea is affected. Therefore, only those affected portions are replaced. Around the year 2000, some corneal surgeons started with performing Deep Lamellar Endothelial Keratoplasty (DLEK), which phased out starting around 2004 by Descemet Stripping Endothelial Keratoplasty (DSEK) procedure by most corneal surgeons.

IEK -- IntraLase Enabled Keratoplasty

DLEK and DSEK are procedures that help with inner tissue failure of the cornea typical of Fuchs' Endothelial Dystrophy or surgical trauma. However, when the cornea is scarred, and the entire cornea needs to be replaced. IEK provides a truly modern way of performing this surgery. Many of the phrases mentioned here are concepts that Roger F. Steinert, MD, Professor and Chairman of Ophthalmology, University of California, Irvine has advanced. As one of Dr. Ash's mentors, and a leading cornea specialist and scientist, Dr. Steinert's work has catapulted corneal transplant surgery to a new era.

Cornea may be compared to furniture for simple illustration. A poor quality piece of furniture may have boards simply nailed together at the ends. As one knows, after some stress the boards loosen, lose strength and eventually fall apart. A more extravagant and sturdy piece of furniture may have boards that are Dovetail joined together. See image of a dovetail joint for better demonstration.

The standard corneal transplant surgery, may be in many ways considered similar to straight nailed joints. The standard wounds many not carry the same strength. Additionally, they may not have perfectly matching surfaces, leading to much corneal irregularity and corneal astigmatism. IEK wounds are similar to dovetailed joint as the interdigitation of the corneal tissues provide greater surface area to heal in a more precisely aligned fashion. This should lead to greater wound strength and reduced corneal astigmatism. See the Visante image of a patient of Dr. Ash that had IEK in July 2007. At that time, about 400 IEK procedures had been done worldwide by fewer than 50 corneal specialists. Dr. Ash is the first corneal surgeon to perform this procedure in Northern California.

Look at the wound edge of the corneal transplant more carefully, one can clearly tell the Zig Zag pattern.

Here is a cartoon of an IEK zigzig pattern.