Our Summary

This research paper discusses the common issues and potential solutions for failed corneal transplants. The cornea is the clear front surface of the eye, and its transplantation is the most frequent tissue transplant procedure globally. However, due to its popularity, there’s a significant issue with the transplants failing.

Recent developments in a type of transplant called ’lamellar transplant’ have brought new specific complications that can lead to graft failure. However, these new techniques also offer innovative ways to rescue failed grafts, with potential advantages such as reduced risks during surgery and faster recovery of vision.

The paper talks about how often graft failure happens and the risk factors for both penetrating (traditional) and lamellar (new type) corneal transplants. It also explores the different surgical alternatives available to save failed grafts, focusing on their results and limitations.

FAQs

  1. What is the most common tissue transplant procedure globally?
  2. What are the potential advantages of the new techniques in lamellar corneal transplants?
  3. What are the risk factors for graft failure in both penetrating and lamellar corneal transplants?

Doctor’s Tip

One helpful tip a doctor might tell a patient about corneal transplant is to carefully follow post-operative instructions provided by their surgeon. This may include using prescribed eye drops, avoiding rubbing or putting pressure on the eye, and attending follow-up appointments to monitor healing progress. By following these instructions, patients can help ensure the success of their corneal transplant and minimize the risk of complications or graft failure.

Suitable For

Patients who may be recommended for a corneal transplant include those with the following conditions:

  1. Keratoconus: a progressive thinning and bulging of the cornea, leading to distorted vision.
  2. Fuchs’ dystrophy: a condition where the inner layer of the cornea (endothelium) fails to pump out water, causing swelling and clouding of the cornea.
  3. Corneal scarring: caused by trauma, infection, or previous surgeries, resulting in decreased vision.
  4. Corneal degenerations: such as lattice dystrophy or macular dystrophy, which can lead to vision loss.
  5. Corneal edema: excessive fluid accumulation in the cornea, causing haziness and visual disturbances.

It is essential for patients with these conditions to undergo a thorough evaluation by an ophthalmologist to determine if a corneal transplant is the best option for improving their vision and quality of life. The decision to undergo a corneal transplant should be made after considering all potential risks and benefits, as well as discussing alternative treatment options.

Timeline

Before corneal transplant:

  1. Patient experiences vision problems, such as blurry or distorted vision, due to a damaged or diseased cornea.
  2. Patient undergoes a comprehensive eye examination to determine if a corneal transplant is necessary.
  3. Patient is placed on a waiting list for a donor cornea.
  4. Once a donor cornea becomes available, patient undergoes the corneal transplant surgery.

After corneal transplant:

  1. Patient may experience some discomfort, light sensitivity, and blurred vision immediately following the surgery.
  2. Patient will be prescribed eye drops to prevent infection and promote healing.
  3. Patient will have regular follow-up appointments with their ophthalmologist to monitor the healing process and adjust medications as needed.
  4. It may take several months for the patient’s vision to fully stabilize and improve after the transplant.
  5. Patient will need to continue with regular eye exams and follow-up care to ensure the long-term success of the corneal transplant.

What to Ask Your Doctor

  1. What are the potential reasons for a corneal transplant to fail?

  2. How common is graft failure in both traditional penetrating and newer lamellar corneal transplants?

  3. What are the specific risk factors for graft failure in each type of corneal transplant?

  4. What are the signs and symptoms that a patient should look out for that may indicate a potential graft failure?

  5. What are the available surgical options to rescue a failed corneal transplant, and what are their success rates?

  6. What are the potential advantages and disadvantages of lamellar corneal transplants compared to traditional penetrating transplants in terms of graft failure rates?

  7. How soon after a failed corneal transplant should a patient consider undergoing a rescue procedure?

  8. What is the recovery process like for patients who undergo a rescue procedure for a failed corneal transplant?

  9. Are there any lifestyle changes or precautions that a patient should take to reduce the risk of graft failure after a corneal transplant?

  10. What are the long-term implications of experiencing graft failure in terms of vision and overall eye health?

Reference

Authors: Alió Del Barrio JL, Bhogal M, Ang M, Ziaei M, Robbie S, Montesel A, Gore DM, Mehta JS, Alió JL. Journal: Surv Ophthalmol. 2021 Jan-Feb;66(1):20-40. doi: 10.1016/j.survophthal.2020.10.003. Epub 2020 Oct 14. PMID: 33065176