DMEK eye surgery at University Hospitals makes a world of difference for Ohio resident

Jan 12 2015

"I was blind as a bat," said 73-year-old Parma, Ohio, resident John Barsa, who suffered from corneal edema, causing an abnormal accumulation of liquid in the eye leading to swelling of the cornea.

"It was like looking through dirty water," said Mr. Barsa. "Everything was blurry.
I needed a bright LED light to read and a magnifying glass. I was acting like an old man."

On top of the inconvenience, Mr. Barsa experienced severe pain. "My eyes would develop blisters and the blisters would break."

The cornea sits on top of the colored part of the eye acting like a windshield. The formal name for Mr. Barsa's condition is Fuchs Endothelial Corneal Dystrophy and it is related to a genetic predisposition. Cataract surgery a couple of years ago could not help improve his vision, but a different type of eye surgery at University Hospitals (UH) Case Medical Center last summer made a world of difference for him.

"Although I'm still wearing glasses, it is a slight prescription," said Mr. Barsa. "It's like the difference between night and day for me. I'm seeing better than I have in years and I don't have the pain anymore."

Mr. Barsa had a procedure in his right eye called DMEK (pronounced DEE-mek), which is short for Descemet membrane endothelial keratoplasty. In DMEK, a very thin, delicate sheet of corneal cells is transplanted. The sheet of cells is only about 1/100 of the thickness of a dime. (His left eye had been previously treated with an older procedure called DSAEK -- Descemet stripping automated endothelial keratoplasty - which involves more layers of corneal tissues. The vision in his left eye improved dramatically as well.)

Mr. Barsa was the first patient at UH to have DMEK.

"DMEK is a great procedure because it has a lot of really good advantages," said Pankaj Gupta, MD, MS, the eye surgeon who developed the DMEK transplant program for UH and who is the Director of Anterior Segment/Cornea and External Disease/Refractive Surgery in the UH Eye Institute. "One, it's a smaller incision than older transplants. Now, we create these incisions that are very tiny.

"The second reason is the graft rejection rate has decreased. We're at the order of less than one percent getting graft rejection over the course of a couple of years with this type of surgery," said Dr. Gupta, who is also a Clinical Instructor in Ophthalmology at the Case Western Reserve University School of Medicine.

"The third one that's really, really important is our ability to finally get people back to 20/20 vision or at least as close as we possibly can.

"It's probably one of the best things that we can do for our patients. It provides them the best vision possible and it is a surgery that gives me a lot of comfort and joy knowing that at the end of the day, I have a patient that's going to successfully be able to do a lot of the things that they want to do for the rest of their life," he said.

Since Mr. Barsa' procedure in 2014, a dozen other patients have had the procedure with good results, and twice as many are expected in 2015.

Mr. Barsa, who is a retired auto parts salesman, has been married for 52 years to Barbara Barsa. They have five children and nine grandchildren.

As for the results, Mr. Barsa said, "I forgot how nice colors were because everything was kind of gray. And all colors are vivid to me now and shapes are very, very sharp now. I can make things out with no problem at all; 100 percent better. There's no comparison."

He felt so confident about his vision that around Thanksgiving he went hunting for turkey, focusing with his newly operated on eye. "I hit my target!" he said.

SOURCE University Hospitals