Cornea Transplant Surgery

Types of Cornea Transplant Surgeries:

There are several types of cornea transplant surgeries, each tailored to different parts of the cornea and specific conditions. Here’s an overview in simple terms:

• Penetrating Keratoplasty (PK) – Penetrating Keratoplasty is a full-thickness cornea transplant, where the entire damaged cornea is replaced with a healthy one. It’s used for severe corneal damage affecting multiple layers.
  
• Endothelial Keratoplasty (EK) – In this procedure, only the innermost layer of the cornea (called the endothelium) is replaced. It’s often done for conditions like Fuchs' dystrophy, where only the inner layer is damaged. Types include:
  
  • DSEK (Descemet’s Stripping Endothelial Keratoplasty) – Removes the damaged inner layer and replaces it with a thin piece of donor tissue.
    DMEK (Descemet’s Membrane Endothelial Keratoplasty) – A more advanced version that uses even thinner donor tissue, allowing quicker healing and clearer vision.
    
  • Anterior Lamellar Keratoplasty (ALK) – This surgery replaces only the outer layers of the cornea. It’s useful when damage is limited to these layers, leaving the deeper layers intact. Types include:
    
• DALK (Deep Anterior Lamellar Keratoplasty) – Replaces nearly all outer layers of the cornea but keeps the healthy inner layer intact, which can reduce the risk of rejection.
• Keratoprosthesis (KPro) – For severe cases where a donor cornea isn’t suitable or has failed previously, an artificial cornea can be implanted. This is usually a last-resort option for very advanced corneal disease.

Benefits of a Cornea Transplant:

• Improved Vision: A cornea transplant can help clear up blurry or cloudy vision, making it easier to see clearly.
• Reduced Pain: For people with corneal diseases causing discomfort or pain, a transplant can help relieve these symptoms.
• Enhanced Quality of Life: Better vision and comfort can make daily activities like reading, driving, and working easier and more enjoyable.
• Increased Independence: Improved eyesight allows more independence in day-to-day life, helping with tasks that require good vision.

Risks of a Cornea Transplant:

• Rejection of Donor Cornea: The body’s immune system may sometimes attack the new cornea, causing redness, pain, or vision problems. This is known as transplant rejection.
• Infection: Like any surgery, there’s a risk of infection. Special eye drops are given to reduce this risk, but infections can still happen and may require additional treatment.
• Vision Issues: Vision may take a while to stabilize after surgery. Some people may still need glasses or contacts to see clearly.
• Glaucoma: Sometimes, the pressure inside the eye can increase after a transplant, leading to glaucoma, which may need treatment.
• Swelling or Scarring: Swelling in the cornea or scarring from the surgery can sometimes affect vision and require further care.
• Detached Retina: In rare cases, the retina (the back part of the eye) may detach, which is a serious condition that requires prompt treatment.

Before the Cornea Transplant Surgery:

Medical check-ups Initially, the doctor examines the patient's eyes, checks their overall health, and discusses their medical history to ensure the patient is a good candidate for the transplant.

• Eye Measurements: Detailed measurements of the patient eye are taken to help select the right size of donor cornea.
• Donor Matching: A healthy donor cornea is selected from an eye bank, matched to the patient's eye requirement.
• Medications: The patient may be prescribed antibiotics or anti-inflammatory eye drops to prepare your eye and reduce infection risk.
• Fasting and Preparation: During the day of surgery, Patient may need to avoid food or drink for a few hours and arrange for someone to drive you home afterward.

During the Cornea Transplant Surgery:

• Anesthesia: Initially Paitent received local anesthesia (numbing eye drops or injections) or, in some cases, general anesthesia to make you comfortable.
• Eye Preparation: The surgeon uses special tools to keep your eye open and stable during the procedure.
• Removal of Damaged Cornea: The damaged part (or whole) of your cornea is carefully removed.
• Donor Cornea Placement: The healthy donor cornea or the specific layer needed is placed onto your eye.
• Stitching or Bonding: Tiny stitches are often used to hold the new cornea in place. The type of stitches and their number depend on the type of transplant.
• Completion and Bandaging: The surgery usually takes 1-2 hours, after which a protective shield or bandage is placed over your eye.

After the Cornea Transplant Surgery:

• Immediate Recovery: Patient rest for a short time after cornea transplant surgery, then be allowed to go home, usually with someone to assist you.
• Follow-Up Visits: Regular follow-up appointments are necessary to monitor healing and prevent complications.
  
• Eye Drops and Medication: Anti-inflammatory and antibiotic eye drops will be prescribed to reduce swelling, prevent infection, and help the eye to accept the transplant.
• Protective Eye Shield: It is required for the patient to wear a shield or patch while sleeping to protect the eyes.
  
• Avoiding Strain: Avoid rubbing your eye, heavy lifting, bending, or other activities that may strain your eye for a few weeks.
• Gradual Vision Improvement: Vision may be blurry at first and can take weeks or months to improve as the eye heals.
• Stitch Removal (if needed): Stitching may be removed or adjusted in follow-up visits, depending on how the eye is getting heal.

Long-Term Care:

• Routine Check-Ups: Periodic visits to the eye doctor are important to ensure long-term success.
• Lifelong Eye Drops (sometimes): Some people may need ongoing eye drops to prevent rejection of the donor tissue.
• Eye Health Maintenance: Follow doctor’s advice on lifestyle, eye protection, and future treatments if needed, to keep your vision stable.keeps the healthy inner layer intact, which can reduce the risk of rejection.
• Keratoprosthesis (KPro): For severe cases where a donor cornea isn’t suitable or has failed previously, an artificial cornea can be implanted. This is usually a last-resort option for very advanced corneal disease.