A cornea transplant is a surgical procedure that uses healthy tissue from an organ donor to replace diseased or scarred corneal tissue. Traditional, full thickness cornea transplants and back layer transplants are the two main types of cornea transplants.
The cornea is a clear, dome-shaped surface in front of your eyes. It acts as a protective barrier, preventing outside dust particles, germs, and bacteria from entering. Light can also enter your eyes through the cornea. The cornea can easily repair minor injuries or scratches without interfering with your vision.
Accidental trauma or serious injuries, on the other hand, may permanently damage the cornea and necessitate immediate consultation with an eye specialist for cornea treatment. Let's see all about the cornea transplant:
What is the Cornea?
The cornea is the transparent, outermost layer of your
eyes. Light rays can pass through the cornea and focus on the retina, the
light-sensitive layer at the back of the eye. The cornea becomes cloudy or
distorted when it is damaged. This can prevent light from reaching the retina,
resulting in blurred vision and, in extreme cases, blindness.
What procedures are used in cornea transplant surgery today?
The type of cornea transplant depends on the extent of
the disease and the amount of cornea that needs to be replaced. There are
currently two main techniques:
ü Keratoplasty with penetration is also known as
a full-thickness cornea transplant. It completely replaces the cornea.
ü Transplantation of the Lamellar Cornea is also
referred to as a partial-thickness corneal transplant. This includes techniques
such as anterior lamellar keratoplasty (ALK) and endothelial keratoplasty.
Your surgeon will determine the best technique for you
after a preoperative examination and depending on the condition of the
patient's cornea.
Who needs a Corneal Transplant?
A corneal transplant is advised for a variety of reasons.
The corneal transplant may benefit patients suffering from the following
conditions:
ü Fuchs' dystrophy is a condition that causes
the innermost layer of your cornea to degenerate.
ü Keratoconus is a condition that causes the
clear tissue at the front of the eye to bulge outward.
ü Lattice dystrophy is an eye disorder that
causes frequent corneal erosions.
ü The cornea is thinning.
ü Scarring, cloudiness, or swelling in the area
around the cornea
ü A corneal ulcer that is usually caused by a
scratched cornea
How to prepare for a corneal transplant?
In the clinic, an eye specialist examines the patient's eyes
first, taking precise measurements and detecting any underlying health
conditions. If you have a disease or are taking medication, notify your doctor
so that the medicines do not interfere with your body's functioning. Use these
recommendations the day before surgery:
- After midnight, avoid all food and beverages.
- Before going to the clinic, dress in loose, comfortable, and breathable clothing.
- Don’t apply eyeshadow, cream, or moisturizer to your face.
- After surgery, request a friend or family member to drive you home.
Before procedure
You will either be given a sedative to help you relax and
a local anesthetic to numb your eye on the day of your cornea transplant, or
you will be put to sleep. In either case, you should not be in pain. At a time, one eye is being operated on.
The length of time spent in surgery varies depending on your
circumstances.
After procedure
After receiving a cornea transplant, you can anticipate:
- Get your medications
Eyedrops that suppress the immune system aid in the
prevention of corneal rejection. Eyedrops and, in some cases, oral medications
will help control infection, swelling, and pain immediately after cornea
transplant and during recovery.
- Wear safety glasses
Eye shields or glasses will keep your eye safe while it
heals.
- Lie down on your back
You might need to continue doing this for a while
following surgery to make sure the new tissue stays in place, depending on the
type of transplant.
- Avoid getting hurt
Avoid rubbing or pressing on your eye. You might need to
continue doing this for a while following surgery to make sure the new tissue
stays in place, depending on the type of transplant. You will have to take
extra precautions for the rest of your life to avoid damaging your eye.
- Return for regular check-ups
You should plan to visit your eye doctor frequently for
the first year after surgery to check on your recovery and look for any
complications.
Different types of Corneal Transplants
1. Deep Anterior Lamellar Keratoplasty
A deep anterior lamellar keratoplasty is a corneal
transplant that only replaces the anterior cornea. Remember that the
endothelium contains specialized pumps that remove excess fluid from the
cornea, keeping it slightly dehydrated. Corneal endothelial cells are extremely
delicate. If it get hurt, they cannot fix themselves.
As a result, many surgeons will try to avoid putting any
stress on the cornea's endothelial layer whenever possible to preserve and
maximize endothelial function. Another advantage of DALK over full thickness
penetrating keratoplasty is that less tissue is transplanted, lowering the risk
of graft rejection. Advanced keratoconus and Acanthamoeba infections are
commonly treated with the DALK procedure.
2. Descemet Stripping Automated Endothelial Keratoplasty
Another type of selective corneal transplant is a Descemet stripping automated endothelial keratoplasty. The stroma, Descemet's layer, and endothelium are removed and replaced during DSAEK.
While a DSAEK is
difficult to perform, it is preferred over a PK in some cases to reduce the
risk of graft rejection because less tissue is replaced in a DSAEK than in a
PK. DSAEK procedures are most commonly used to treat advanced Fuch's
endothelial dystrophy or other rare endothelial disorders.
3. Descemet Membrane Endothelial Keratoplasty
While advanced surgical techniques are required, DMEKs
are advantageous for patients because they preserve the greatest amount of host
tissue, making this type of transplant debatably the safest with the least
likelihood of graft rejection. DSAEK is a procedure typically used to treat
advanced stage Fuch's endothelial dystrophy and other endothelial disorders.
Cornea Transplant in India
Summing it up
The cornea transplant surgery can repair minor injuries or scratches without impairing your vision. In contrast, accidental trauma or serious injuries may permanently damage the cornea, necessitating immediate consultation with an eye specialist for cornea treatment. Thus the above listed are about the cornea transplant.
