Our Summary

Corneal blindness, a type of reversible blindness, can be treated through the transplantation of a healthy cornea from a donor. This type of organ transplantation is often successful because the cornea does not contain blood vessels, which lessens the chance of the body rejecting the new tissue. Since the first successful transplant by Zirm, this field has seen a lot of progress due to continuous research and advancements in technology and knowledge about the cornea. Previously, the whole cornea was replaced, but now, only the affected layer is replaced, making the procedure safer and more effective. Corneal transplantation methods fall into two categories: full-thickness penetrating keratoplasty and partial lamellar corneal surgeries. The latter includes procedures such as superficial anterior lamellar keratoplasty, automated lamellar therapeutic keratoplasty, deep anterior lamellar keratoplasty, Descemet stripping automated endothelial keratoplasty, and Descemet membrane endothelial keratoplasty.

FAQs

  1. What is corneal blindness and can it be treated?
  2. Why is corneal transplantation often successful?
  3. What are the different methods of corneal transplantation?

Doctor’s Tip

It is important to follow post-operative instructions carefully, including using prescribed eye drops to prevent infection and aid in healing. It is also important to attend follow-up appointments with your eye doctor to monitor progress and ensure the success of the transplant. In some cases, glasses or contact lenses may be needed to achieve the best possible vision after surgery. Remember, each individual’s experience with corneal transplant surgery may vary, so it is important to communicate openly with your doctor about any concerns or questions you may have throughout the process.

Suitable For

Patients who are typically recommended for a corneal transplant include those with:

  1. Corneal scarring or clouding: This can be caused by infections, injuries, or certain eye conditions such as keratoconus.

  2. Keratoconus: A progressive condition where the cornea thins and bulges outward, causing distorted vision.

  3. Fuchs’ dystrophy: A condition where the inner layer of the cornea (endothelium) does not function properly, leading to swelling and vision problems.

  4. Corneal degeneration: Age-related changes in the cornea can lead to decreased vision and may require a transplant.

  5. Corneal injury: Trauma to the eye that results in damage to the cornea may require a transplant to restore vision.

  6. Previous failed corneal surgery: In cases where previous corneal surgery has not been successful, a transplant may be recommended.

  7. Corneal infections: Severe infections that do not respond to medication may require a transplant to prevent further damage to the eye.

It is important for patients to undergo a thorough evaluation by an eye care professional to determine if a corneal transplant is the best option for their specific condition.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with corneal blindness or other corneal conditions that cannot be treated through other means.
  2. Patient undergoes a thorough eye examination to determine the extent of damage to the cornea and whether they are a suitable candidate for a transplant.
  3. Patient is placed on a waiting list for a donor cornea, which can take several months to years depending on availability.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are in good health and prepared for surgery.

After corneal transplant:

  1. Patient undergoes the corneal transplant surgery, which can be performed under local or general anesthesia depending on the type of procedure.
  2. Patient may experience discomfort, blurry vision, and sensitivity to light in the days following surgery.
  3. Patient is prescribed medications to prevent infection and reduce inflammation, as well as lubricating eye drops to promote healing.
  4. Patient attends follow-up appointments with their ophthalmologist to monitor the success of the transplant and ensure proper healing.
  5. Patient may need to wear an eye shield at night and avoid rubbing or putting pressure on the eye to protect the new cornea.
  6. Patient may require vision rehabilitation and adjustments to their eyeglass prescription as their vision improves.
  7. Patient experiences improved vision and quality of life as the transplanted cornea heals and integrates into the eye.

What to Ask Your Doctor

  1. What type of corneal transplant surgery do you recommend for my specific condition?
  2. What are the potential risks and complications associated with corneal transplant surgery?
  3. How long is the recovery period after corneal transplant surgery?
  4. What post-operative care and follow-up appointments will be necessary?
  5. What are the success rates of corneal transplant surgery for my specific condition?
  6. How long will the transplanted cornea last before another transplant may be needed?
  7. What are the chances of rejection of the transplanted cornea and how can it be prevented?
  8. How will my vision be affected after corneal transplant surgery?
  9. Are there any lifestyle changes or restrictions I should be aware of after surgery?
  10. What are the alternatives to corneal transplant surgery for treating my condition?

Reference

Authors: Singh R, Gupta N, Vanathi M, Tandon R. Journal: Indian J Med Res. 2019 Jul;150(1):7-22. doi: 10.4103/ijmr.IJMR_141_19. PMID: 31571625