Corneal Transplant Surgeries

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Corneal transplantation, also known as corneal grafting, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft) in its entirety (penetrating keratoplasty) or in part (lamellar keratoplasty). The graft has been removed from a recently deceased individual with no known diseases that may affect the viability of the donated tissue. The cornea is the transparent front part of the eye that covers the iris, pupil and anterior chamber.

Indications for corneal transplantation:

Scarring from infections, such as eye herpes or fungal Keratitis

Hereditary factors or corneal failure from previous surgeries

Thinning of the cornea and irregular shape (such as with Keratoconus)

Chemical burns on the cornea or damage from eye injury

Excessive swelling (edema) on the cornea

Types of Keratoplasty:

1. Penetrating keratoplasty

The surgeon removes a circular disc of the patient’s cornea and replaces it by donor cornea using stitches.

2. Lamellar keratoplasty

This procedure consists in leaving just the patient’s own Descemet’s membrane and endothelium, while transplanting approximately 95% of the cornea. The great advantage of this technique is the virtually “no rejection post-operative rejection”

3. Descemet’s Stripping (Automated) Endothelial Keratoplasty (DSAEK)

A new version of corneal transplant, known as DSAEK, also has been introduced as anew surgical method that uses only a very thin portion of the cornea for transplant.

Not all patients with diseased corneas are candidates for endothelial keratoplasty. These procedures correct corneal endothelial failure, but are not able to correct corneal scarring, thinning, or surface irregularity

4. Boston Keratoprosthesis

The Boston Keratoprosthesis is the most widely used synthetic cornea to date with worldwide.

Prognosis:

While most people undergoing a cornea transplant can expect a good outcome, graft rejection can occur. However, medical management of graft rejection often can lead to healthy graft survival. A major study with an eight month follow up found a graft survival rate of about 93 percent in people who had undergone a corneal transplant.