Methods employed in replacement of the corneal endothelium

Abstract

Prosthetic devices and methods are described that can be employed in replacing corneal endothelial tissue to allow the diseased or damaged corneal endothelial tissue to be replaced without replacing the outer layers of the patient's cornea and/or to replace the full thickness of the cornea in a manner resulting in less deformation of the outermost surface of the cornea (i.e. less astigmatism) than occurs with current full thickness transplant techniques. A partial outer thickness of tissue is removed from a patient's cornea by making a cut generally transverse to the axis of vision; a plug of the remaining portion of the patient's cornea from the area in which the outer thickness of tissue was removed is removed, the plug including Descemet's membrane and corneal endothelial cells, thereby forming a bore through the cornea; and an ocular implant sized and shaped to fit closely in said bore and to cover the area of the remaining portion of the patient's cornea from which the outer thickness of tissue was removed is placed in the bore. A corneal prosthesis of the invention includes a dome-shaped anterior cap component sized and configured to replace a partial thickness anterior portion of a cornea of an eye, and a posterior plug component extending posteriorly of the anterior portion sized and configured to replace a full thickness portion of the cornea, the plug component having a width smaller than the width of the cap component.