Our Summary

The research paper discusses how Endothelial keratoplasty (EK), a type of corneal transplant surgery, has greatly improved the speed and quality of vision recovery. This procedure is particularly relevant in parts of the world where Fuchs endothelial dystrophy, a disease that causes vision problems, is prevalent. Many patients with this condition also suffer from cataracts, another eye disease that causes clouding of the lens.

The paper examines the decision-making process regarding whether to conduct cataract surgery and EK either together or separately. This decision is influenced by factors such as the skill of the surgeon, the specifics of the surgical techniques under consideration, and the degree of damage to the eye. Other important considerations include the type of lens implant to use, the patient’s desired vision outcome, and the patient’s preference about undergoing one or two surgeries per eye. The researchers currently use a technique called phacoemulsification to remove cataracts and perform both cataract surgery and EK under topical anesthesia.

FAQs

  1. What is Endothelial keratoplasty (EK) and who is it most relevant for?
  2. What factors influence the decision to conduct cataract surgery and EK either together or separately?
  3. What is the technique called phacoemulsification used for in the context of eye surgeries?

Doctor’s Tip

A doctor may advise a patient undergoing a corneal transplant to follow their post-operative care instructions carefully, including using prescribed eye drops, avoiding rubbing the eyes, and attending all follow-up appointments. They may also recommend wearing protective eyewear to prevent injury to the eye during the healing process. Additionally, the doctor may suggest avoiding activities that could put strain on the eyes, such as heavy lifting or strenuous exercise, until fully healed.

Suitable For

Patients who are typically recommended for corneal transplant surgery include those with conditions such as Fuchs endothelial dystrophy, keratoconus, corneal scarring, corneal edema, and corneal degeneration. These conditions can cause significant visual impairment and affect the overall health of the eye. Additionally, patients who have undergone previous corneal surgeries that have been unsuccessful may also be candidates for corneal transplant.

In the case of Fuchs endothelial dystrophy, patients may experience symptoms such as blurry or cloudy vision, glare, and light sensitivity. These symptoms can significantly impact a patient’s quality of life and ability to perform daily activities. Corneal transplant surgery can help improve vision and alleviate these symptoms, leading to a better overall quality of life for the patient.

It is important for patients to undergo a thorough evaluation by an ophthalmologist to determine if they are suitable candidates for corneal transplant surgery. The ophthalmologist will assess the severity of the condition, the overall health of the eye, and the potential benefits and risks of the surgery. Additionally, patients should discuss their expectations and goals for the surgery with their healthcare provider to ensure that they have realistic expectations about the outcome.

Overall, corneal transplant surgery can be a life-changing procedure for patients with certain eye conditions. By improving vision and reducing symptoms, patients can enjoy a better quality of life and regain their independence.

Timeline

Before the corneal transplant surgery, patients typically undergo a comprehensive eye examination to determine the extent of their vision impairment and the underlying cause. This may involve tests such as corneal topography, endothelial cell count, and visual acuity testing. The patient will also be evaluated for any other eye conditions that may affect the success of the surgery.

After the decision is made to proceed with the corneal transplant, the patient will undergo pre-operative preparations such as obtaining medical clearance, discontinuing certain medications, and following any specific instructions provided by the surgeon. On the day of the surgery, the patient will arrive at the surgical facility and undergo the transplant procedure under local or general anesthesia.

Following the surgery, the patient will be monitored closely for any signs of complications such as infection or rejection of the transplanted tissue. The patient will also be prescribed medications to prevent infection and reduce inflammation, as well as instructions for post-operative care such as eye drops and follow-up appointments.

In the weeks and months following the surgery, the patient will gradually experience improvements in their vision as the transplanted tissue heals and stabilizes. Regular follow-up appointments will be scheduled to monitor the progress of the transplant and make any necessary adjustments to the treatment plan. Overall, the goal of the corneal transplant surgery is to improve the patient’s vision and quality of life.

What to Ask Your Doctor

  1. What is the success rate of corneal transplant surgery in general, and specifically for patients with my condition?

  2. How experienced are you in performing endothelial keratoplasty (EK) surgery?

  3. What are the potential risks and complications associated with EK surgery?

  4. How long is the recovery process after EK surgery, and what can I expect in terms of vision improvement?

  5. Will I need to take any medications or follow a specific post-operative care regimen after EK surgery?

  6. What type of lens implant do you recommend for me, and how will it affect my vision?

  7. Can cataract surgery and EK be performed at the same time, or should they be done separately? What are the pros and cons of each approach?

  8. What are the alternatives to EK surgery, and how do they compare in terms of success rates and recovery times?

  9. Will I need to undergo additional surgeries or treatments in the future after EK surgery?

  10. How will EK surgery improve my quality of life and overall vision in the long term?

Reference

Authors: Price FW Jr, Price MO. Journal: Asia Pac J Ophthalmol (Phila). 2017 Jul-Aug;6(4):388-392. doi: 10.22608/APO.2017127. Epub 2017 Jun 20. PMID: 28726355