Our Summary

The research paper discusses the challenges of treating diseases that affect the outer edge of the cornea in the eye, such as Mooren’s ulcer, Terrien’s marginal degeneration, peripheral ulcerative keratitis and pellucid marginal degeneration. Traditional methods involve using circular grafts, which can either be too large, leading to the removal of healthy tissue, or off-center, causing high levels of astigmatism.

The paper highlights the usefulness of noncircular grafts in managing these diseases. These grafts offer structural support to the cornea and help improve vision. The outcomes after surgery have been generally positive, with good visual results and acceptable levels of astigmatism.

However, the paper also mentions that most of the evidence supporting these procedures comes from case reports and smaller studies, with no large-scale studies available. Therefore, the article concludes that more extensive studies are needed to fully understand the pros and cons of these procedures and to better define their results.

FAQs

  1. What diseases affecting the outer edge of the cornea can be treated with noncircular grafts?
  2. What are the advantages and disadvantages of using noncircular grafts in corneal transplant surgeries?
  3. What evidence supports the effectiveness of noncircular grafts, and why are more extensive studies needed?

Doctor’s Tip

In terms of helpful tips, a doctor might tell a patient undergoing a corneal transplant to follow all post-operative instructions carefully, including using prescribed eye drops and medications, attending all follow-up appointments, protecting the eye from injury, and avoiding activities that could strain the eye. It’s also important for the patient to be patient with the healing process, as it can take time for vision to fully improve after surgery. Lastly, maintaining overall eye health through regular check-ups and following a healthy lifestyle can help ensure the long-term success of the corneal transplant.

Suitable For

Patients who are typically recommended for corneal transplant include those with conditions such as Mooren’s ulcer, Terrien’s marginal degeneration, peripheral ulcerative keratitis, and pellucid marginal degeneration. These conditions can cause significant damage to the cornea, leading to visual impairment and discomfort. Patients who have not responded well to other forms of treatment may be considered for corneal transplant as a last resort to improve vision and quality of life. Additionally, patients with corneal scarring, corneal dystrophies, or corneal injuries may also be candidates for corneal transplant.

Timeline

Before corneal transplant:

  1. Patient experiences symptoms such as blurred vision, sensitivity to light, eye pain, and irritation.
  2. Patient undergoes a comprehensive eye examination to determine the extent of corneal damage.
  3. Patient is informed about the need for a corneal transplant and the potential risks and benefits of the procedure.
  4. Patient undergoes preoperative tests to assess overall health and suitability for surgery.

After corneal transplant:

  1. Patient undergoes the corneal transplant surgery, which involves removing the damaged cornea and replacing it with a healthy donor cornea.
  2. Patient is monitored closely in the immediate postoperative period for any complications or signs of rejection.
  3. Patient may experience temporary discomfort, blurred vision, and light sensitivity as the eye heals.
  4. Patient follows a strict postoperative care regimen, including using prescribed eye drops and attending follow-up appointments.
  5. Over time, the patient’s vision gradually improves as the new cornea integrates and heals.
  6. Patient may require glasses or contact lenses to achieve optimal vision after the transplant.
  7. Long-term follow-up is necessary to monitor for signs of rejection or other complications and to ensure the health and stability of the transplanted cornea.

What to Ask Your Doctor

  1. What is the success rate of noncircular grafts compared to traditional circular grafts?
  2. How long is the recovery process after a corneal transplant using noncircular grafts?
  3. What are the potential risks and complications associated with noncircular grafts?
  4. Will I need to take immunosuppressant medications after the surgery?
  5. How often will I need to follow up with you after the surgery?
  6. What kind of post-operative care will be required?
  7. Are there any specific lifestyle changes I should make to ensure the success of the transplant?
  8. How will my vision be affected in the long term after the surgery?
  9. What can I expect in terms of astigmatism correction after the procedure?
  10. Are there any alternative treatment options I should consider before opting for a corneal transplant?

Reference

Authors: Deshmukh R, Stevenson LJ, Vajpayee RB. Journal: Curr Opin Ophthalmol. 2020 Jul;31(4):293-301. doi: 10.1097/ICU.0000000000000672. PMID: 32412959