Eye Institute of West Florida
Neel R. Desai, MD, is a fellowship-trained ophthalmologist strictly specializing in LASIK, cataract and corneal diseases of the eye. Dr. Desai is a top graduate of the Pennsylvania State University College of Medicine and completed his fellowship in cornea, cataract, and refractive surgery at the Wilmer Eye Institute at Johns Hopkins University. Dr. Desai is in private practice at the Eye Institute of West Florida with offices in Largo, Clearwater, and St. Petersburg, Florida. He is a consultant and speaker for BIO‑TISSUE® and can be reached at (727) 581-8706.
Descemet’s stripping endothelial keratoplasty (DSEK) is currently the treatment of choice over penetrating keratoplasty in cases with bullous keratopathy due to corneal endothelial dysfunction. Advantages include faster recovery and fewer complications. In cases with pseudophakic bullous keratopathy (PBK), the stromal and epithelial edema usually interferes with intraoperative visualization and poses a major technical challenge for DSEK. Debridement of the epithelial blisters may improve the visualization during surgery; however, it creates a large, slow-healing epithelial defect.
Cryopreserved amniotic membrane has been used successfully to treat nonhealing epithelial defects. Early intervention with cryopreserved amniotic membrane via PROKERA® enhances faster healing of a large corneal epithelial defect after DSEK in a case of PBK.
PROKERA® can be used as a temporary biological bandage to restore a healthy corneal epithelium after dseK is used to restore a functioning corneal endothelium.