Corneal transplant surgery; Application, types, improvements and complications

The cornea is the clear layer at the front of the eye that helps focus light for clear vision.... If this part is damaged, it may need to be replaced.

The surgeon removes all or part of the cornea and replaces it with a layer of healthy tissue. The new cornea belongs to the people who donated this tissue at the time of death.

Corneal transplantation, also called keratoplasty, can reduce pain, restore vision, and improve the appearance of the cornea if it is white and scarred.

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Who needs cornea transplant surgery?

The light beam that passes through the damaged cornea may be deflected and affect your vision.

Corneal transplantation is effective in correcting several eye disorders, such as:

• Corneal scar caused by injury or infection
• sores or "scratches" of the cornea caused by infection
• a clinical disease that causes protrusion of the cornea (keratoconus)
• thin, cloudy or swollen cornea
• Hereditary eye diseases, such as focal dystrophy, etc.
• Problems caused by old eye lights

The best eye doctor will let you know which specific method is best for your condition.

Types of cornea transplant surgery

Corneal full thickness graft

If a penetrating cornea transplant (Penetrating Keratoplasty-PK) is performed, all layers of the cornea will be replaced.. The surgeon sews the new cornea into the eye with stitches thinner than a hair.

This method may be performed in case of severe corneal damage or severe protrusion and scarring.

The recovery time of this action is longer.

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Incomplete thickness corneal graft

In deep anterior lamellar keratoplasty (DALK), the surgeon separates the thin outer and thick middle layers of the cornea by injecting air, and then removes and replaces them.

This work may be done in people with keratoconus or corneal scarring where the inner layers of the cornea are not damaged.

The recovery time associated with this method is less than that of a full-thickness corneal transplant... Since the eye itself is not opened, it is unlikely that the lens and iris will be damaged, and as a result, the chance of intraocular infection is less.

Endothelial keratoplasty

About half of the people who need a corneal transplant every year face problems in the innermost layer of the cornea, the endothelium.

Cornea specialists often perform this type of surgery to treat Fuchs' dystrophy and other clinical conditions.

Endothelial keratoplasty with desmectomy (DSEK or DSAEK) is the most common type of endothelial keratoplasty. The surgeon removes the endothelium - just one thick layer of cells - and the desm membrane that lies just above it.. the thick cornea) is attached.

In another type, Desme membrane endothelial keratoplasty (DMEK), only the endothelium and Desme membrane are grafted without the supporting stroma.. Donated tissue is very thin and fragile, so it is more difficult to work with, but recovery from this procedure is usually faster.

A third option for people with Fuchs' dystrophy, if the surrounding cornea is healthy enough to provide cells to fill the removed area, is to remove just the central part of the inner membrane without a graft.

These surgeries are good options for people who only damage the inner layer of the cornea due to faster healing.

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How is the surgery performed?

Before surgery, your doctor will probably do an examination and tests to check your general health.... You may need to stop taking certain medications, such as aspirin, for a few weeks before surgery.

In order to prevent infection, you usually need to use antibiotic drops in your eyes the day before the transplant.

These surgeries are often performed on an outpatient basis under local anesthesia....this means you will be awake, but relaxed and able to go home the same day.

The doctor performs the entire surgery through a microscope... Normally, this process takes 30 minutes to an hour.

Recovery process

You will probably need to wear an eye patch for at least a day or up to 4 days after surgery to allow the top layer of the cornea to heal....your eye will likely be red and sensitive to light....you may feel discomfort or pain for a few days, but some people will not experience any discomfort.

The doctor will prescribe eye drops to reduce inflammation and reduce the chance of infection. He may also prescribe other medications to help with the pain.

In procedures like DSEK and DMEK, which use a gas bubble to help place graft tissue inside the eye, your surgeon may ask you to lie on your back for several days, sometimes during the day and sometimes at night.

After surgery, you need to protect your eyes from damage. Follow your eye doctor's instructions carefully.

Your cornea does not have blood, so the healing process will be slow...

Possible side effects of corneal transplant operation

Corneal transplantation is considered a completely safe procedure, but the process is a surgery, so it comes with risks.

In about 1 out of 10 transplants, the immune system attacks the transplanted tissue.. This is called transplant rejection and is usually reversible with eye drops.. Since DSEK and especially DMEK use limited transplant tissue, the risk of transplant rejection is much lower.

Other things that can happen are:

• infection
• Bleeding
• Increased intraocular pressure (called glaucoma)
• clouding of the lens of the eye (called cataract)
• Swelling of the cornea
• retinal detachment, in which the inner back surface of the eye deviates from its normal position

Summary

Most people who undergo a corneal transplant regain at least some of their vision, but this varies from case to case.... Full recovery of vision may take several weeks to a year... Vision may worsen slightly before improving.

Because the connective tissue is not perfectly round, you may need glasses or contact lenses to correct astigmatism... (5 Common Symptoms of Astigmatism)

After the first year, you should see an eye doctor once or twice a year.. The donated tissue will usually last for life.... For treatment or more information, you can make an appointment online or consult with the cornea specialists at GCORP LLC.