A corneal transplant is a procedure to replace a damaged cornea with either an entire donated cornea, donated corneal tissue or part of a donated cornea. A corneal transplant is carried out to improve sight or relieve pain.
What are the types of Corneal Transplant?
The most common Corneal Transplant procedures are:
Penetrating keratoplasty: This is the most commonly used corneal transplant technique. In this procedure, the surgeon removes a small circle of the patient’s cornea and replaces it with a “full thickness” circular piece of donor cornea. The donor cornea is held in place with stitches.
DALK (Deep anterior lamellar keratoplasty): This corneal transplant technique transplants around 95 percent of the cornea and is used in cases where the cornea lining is healthy but the stroma is diseased. Stitches hold the donor cornea in place.
DSEK (Descemets stripping endothelial keratoplasty): This procedure removes the inner cell layer of the cornea and replaces it with donor cornea tissue. An air bubble, not stitches, holds the donor cornea tissue in place until it bonds with the patient’s cornea.
What surgeon performs Corneal Transplant?
Corneal transplant is carried out by an ophthalmologist surgeon.
Duration of procedure/surgery:
The corneal transplant procedure takes between 1 and 2 hours.
None. The corneal transplant usually takes place on an outpatient basis.
Corneal transplant is most commonly carried out under local anesthesia.
Recovery time depends on the type of surgery. - It can take up to two years for the eye to fully stabilize and vision to settle down after deep anterior lamellar keratoplasty (DALK). - Full visual recovery takes up to three months after a DSEK procedure. - You can usually return to work two to three weeks after the corneal transplant. - The stitches holding the corneal transplant are left in place for one to three years in order for the cornea to heal into place.
Corneal transplant is relatively safe but there is a small risk of serious complications. Risks include: - Infection (the cornea is slow-healing and is at risk of infection during this time). - Cornea graft failure (according to the UK National Health Service retinal detachment occurs in around one percent of corneal transplant patients). - Rejection of the donor cornea (according to the UK National Health Service, one in five corneal transplants will be rejected or partially rejected). - Decreased or blurred vision. - Glaucoma.
Wear an eye patch at night for one to four days following a corneal transplant. - Use medicated eye drops to prevent infection. - Avoid rubbing your eyes. - Avoid strenuous exercise for a few weeks following a corneal transplant and don’t take part in contact sports. - Wear sunglasses to protect the eyes from glare. - Attend follow-up eye exams.
Corneal transplant surgery, also known as corneal transplantation or simply corneal grafting is a surgical procedure in which a diseased or otherwise damaged cornea is replaced with a donated, healthy cornea.
The cornea is the clear tissue that covers the front of the eye and as such, it must remain clear for patients to see properly. The cornea is a sensitive part of the eye, and it can get damaged due to a wide range of reasons, including:
● Corneal scarring from infections or blunt trauma
● Keratoconus – a condition in which the cornea becomes very thin and changes its shape
● Dystrophies – Fuchs’ dystrophy, Lattice dystrophy and many others
There are two types of corneal transplantation or corneal transplant surgery:
● Penetrating keratoplasty – During this procedure, the entire cornea is replaced with a healthy donor cornea – it is also known as a full corneal transplant
● Lamellar keratoplasty – During this procedure, only part of the cornea is replaced – it is also known as a partial corneal transplant
The graft is usually harvested from a recently dead individual with a healthy cornea. It’s worthy to note that although it is a generally successful procedure which provides long-lasting results, corneal transplant surgery is only performed when other types of treatment are ineffective.
Corneal transplant surgery or corneal transplantation has many indications, including:
● Optical – the procedure can improve the patient’s eyesight by removing and replacing any tissue affected by diseases such as keratitis, dystrophy, corneal degeneration, keratoglobus.
● Reconstructive – the procedure is performed to preserve the corneal integrity in patients suffering from descemetoceles or stromal thinning. It can also be used to reconstruct the eye after corneal perforation due to blunt trauma.
● Therapeutic indications – corneal transplant surgery may be performed in order to remove inflamed corneal tissue which cannot be healed through the use of antibiotics.
● Cosmetic indications – corneal transplantation can improve the aesthetics of patients with corneal scars which often leads to a whitening of the eyes.