Corneal Transplantation

Cornea is a transparent front part of the eye, which covered the pupil. It is a window of eye consists of five layers, its function focusing the light on the retina, which transfers the image through optic nerve to brain.

If cornea has opacity then the light passes through it, spreads irregularly, and that causes blurry vision.

Corneal transplant

It is surgical procedure where an ophthalmologist, changes a cornea with a new cornea by donor and fix with tiny surgical stitches. There are different types of corneal transplant, penetrating (full corneal thickness), lamellar (anterior layers) and endothelial (deeper layer). Depending on the surgery, the stitches will remain in eye for 12 – 18 months depending on eye condition, and healing with surrounding tissues. It might be no visual improvement, until removing all the sutures that may last more than one year. The vision during the first weeks after surgery is different from expected vision that you might have after removing the sutures.

 Causes of corneal transplantation

·        Keratoconus, which is diseases, that increases gradually thinning of the cornea resulting blurry vision.

·        Hereditary corneal diseases.

·        Corneal infections that not responded to treatment.

·        Corneal ulcer.

·        Severe corneal injuries that caused corneal opacity.

·        Corneal burns (chemical or electrical).

·        Complications after eye surgeries like cataract or glaucoma

 

 

 Corneal transplant Types  

Penetrating keratoplasty: in this procedure, the surgeon removes corneal all layers, replaced with donor’s corona, and fixes it with sutures.

Lamellar keratoplasty: In this procedure, the surgeon replaces all the damaged corneal layers with healthy donor ones and fix by stitches. Moreover, (it takes more time and might be converted to penetrating keratoplasty during the procedure). The healthy part of the cornea is left untouched to lower risks of corneal rejection.

Descemet’s Stripping Endothelial keratoplasty (DSAEK): in which the inner layer of cornea is removed, and replaced with tissue but attached to the cornea with gas or air instead of stitches for faster healing.

Corneal Rejection

Corneal rejection occurs when the body rejects the new cornea, consider it as foreign body, and start attacking it, rejection may occur in some cases especially with Penetrating keratoplasty, but it is lower with lamellar keratoplasty and DSAEK.

 Corneal rejection been expected at any time and this requires emergency admission in hospital, so if you have any of the following signs you should seek medical assistance directly:

o   Decrease in visual acuity.

o   Redness.

o   Photophobia.

o   Pain.

o   Tearing.

o   Foreign body sensation.

Early diagnosis helps much in the successful treatment of corneal rejection. Usually, the physician prescribes certain medications to help your body accept the corneal graft. Note that the signs of corneal rejection may occur late after the surgery.