What is a Corneal Transplant?
Corneal transplant is a procedure that replaces your cornea, the clear front layer of your eye. During this procedure, your surgeon removes damaged or diseased corneal tissue. Healthy corneal tissue from the eye of a deceased human donor replaces the damaged cornea. For many people, cornea transplant surgery restores clear vision and improves their quality of life.
What symptoms may indicate I need a corneal transplant?
If you have a damaged cornea, you may experience symptoms including:
- Eye pain
- Blurred vision
- Cloudy vision
Your ophthalmologist will determine the cause and other possible treatments that may resolve these symptoms. If your cornea cannot be repaired using other methods, your surgeon may recommend a cornea transplant.
What types of diagnoses indicate I could need a cornea transplant?
Conditions that damage your corneas and impair your ability to see clearly may require a corneal transplant. These conditions include:
- A cornea that bulges outward (keratoconus)
- Fuchs' dystrophy, a hereditary condition
- Thinning or tearing of the cornea
- Cornea scarring, caused by infection or injury
- Swelling of the cornea
- Corneal ulcers not responding to medical treatment
- Complications caused by previous eye surgery
What is needed before the Corneal transplant?
Before cornea transplant surgery, you will undergo:
- A thorough eye exam. Your eye doctor looks for conditions that might cause complications after surgery.
- Measurements of your eye. Your eye doctor determines what size donor cornea you need.
- A review of all medications and supplements you're taking. You may need to stop taking certain medications or supplements before or after your cornea transplant.
- Treatment for other eye problems. Unrelated eye problems, such as infection or inflammation, can reduce your chances of a successful cornea transplant. Your eye doctor will treat those problems before your surgery.
How to find a donor cornea?
Corneas used in cornea transplants come from people who have died. Corneas are not used from people who died from unknown causes or from donors who had certain conditions, such as diseases that can spread, previous eye surgery or eye disease.
Unlike with organs such as livers and kidneys, people needing cornea transplants don't require tissue matching.
What are the procedures to transplant a portion of the cornea?
A cornea transplant removes either the entire thickness or partial thickness of the diseased cornea and replaces it with healthy donor tissue. Your cornea surgeon will decide which method to use. These types of procedures include:
- Penetrating keratoplasty (PK) a full-thickness cornea transplant. Your surgeon cuts through the entire thickness of the abnormal or diseased cornea to remove a small button-sized disk of corneal tissue. A special instrument is used to make this precise circular cut. The donor cornea, cut to fit, is placed in the opening. Your surgeon then uses stitches (sutures) to stitch the new cornea into place. The stitches might be removed at a later visit with your eye doctor.
- Endothelial keratoplasty (EK). These procedures remove diseased tissue from the back corneal layers, including the endothelium and a thin layer of tissue that protects the endothelium from injury and infection (Descemet membrane). Donor tissue replaces the removed tissue.
There are two types of endothelial keratoplasty.
a) The first type, called Descemet stripping endothelial keratoplasty (DSEK), uses donor tissue to replace about one-third of the cornea.
b) The second type, called Descemet membrane endothelial keratoplasty (DMEK), uses a much thinner layer of donor tissue. The tissue used in DMEK is extremely thin and fragile. This procedure is more challenging than DSEK and is commonly used.
- Anterior lamellar keratoplasty (ALK). Two different methods remove diseased tissue from the front corneal layers, including the epithelium and the stroma, but leave the back endothelial layer in place. The depth of cornea damage determines the type of ALK procedure that's right for you. Superficial anterior lamellar keratoplasty (SALK) replaces only the front layers of your cornea, leaving the healthy stroma and endothelium intact. A deep anterior lamellar transplant (DALK) procedure is used when cornea damage extends deeper into the stroma. Healthy tissue from a donor is then attached (grafted) to replace the removed portion.
- Artificial cornea transplant (keratoprosthesis). In some cases, if people aren't eligible for a cornea transplant from a donor cornea, they might receive an artificial cornea (keratoprosthesis).
What to do after Corneal Transplant?
Once your cornea transplant is completed, you can expect to:
- Receive medications. Eyedrops and, sometimes, oral medications immediately after cornea transplant and during recovery will help control infection, swelling and pain. Eyedrops to suppress the immune system help prevent cornea rejections.
- Wear eye protection. Eye shields or glasses protect your eye as it heals.
- Lie on your back. Depending on the type of transplant, you might have to do this for a while after surgery to help the new tissue stay in place.
- Avoid injury. Plan to take it easy after your cornea transplant, and slowly work your way up to your normal activities, including exercise. Don't rub or press on your eye. For the rest of your life, you'll need to take extra precautions to avoid harming your eye.
- Return for frequent follow-up exams. Expect to see your eye doctor regularly in the year after surgery to monitor your progress and look for complications.
Visit Arohi Eye Hospital to consult and get treatment from the Best Corneal Transplant Surgeon in Mumbai. Call: +91-9820111315