Our Summary

This study looked at the reasons for corneal transplants, the types of procedures done, and the results after the surgery. The research was done by looking back at the medical records of patients who had a corneal transplant done by the same eye surgeon between 2008 and 2015.

During that time, 42 corneal transplants were done on 40 eyes of 38 patients. Most of the patients were men, and the average age was 62 years old. The most common reason for needing a transplant was a condition called pseudophakic corneal decompensation, which often happens alongside another eye disease called Fuch’s endothelial dystrophy.

There were three types of corneal transplant procedures done: penetrating keratoplasty, lamellar keratoplasty, and amniotic membrane transplant. The most common procedure was lamellar keratoplasty.

After the surgery, 10% of the transplants failed, causing swelling in the cornea or requiring another transplant surgery. Patients who had a previous transplant failure or who had Fuch’s dystrophy were more likely to have a transplant failure.

One other issue was that in one case, the lens inside the eye became cloudy after a specific type of corneal transplant procedure (DSAEK). This issue, and how it might affect vision, should be discussed with patients before they have this kind of surgery.

In simple terms, the study found that the most common reason for needing a corneal transplant was a specific eye condition, and that there are certain risk factors that make a transplant more likely to fail. It also found that one type of procedure may make the lens inside the eye become cloudy, which could affect vision.

FAQs

  1. What are the common indications for corneal transplantation?
  2. What are the risk factors for postoperative complications in corneal transplant surgeries?
  3. What are the different procedures carried out in corneal transplant surgeries and which is the most common?

Doctor’s Tip

A helpful tip a doctor might tell a patient about corneal transplant is to make sure to follow all postoperative care instructions, including using prescribed eye drops, attending follow-up appointments, and avoiding rubbing or touching the eye. It is also important to protect the eye from injury and avoid activities that could increase the risk of infection. Additionally, patients should be aware of the potential risks and complications associated with the surgery, such as transplant failure or intraocular lens opacification, and discuss any concerns with their doctor.

Suitable For

Patients who are typically recommended for corneal transplant surgery include those with conditions such as pseudophakic corneal decompensation associated with Fuch’s endothelial dystrophy, keratoconus, corneal scarring, corneal infections, and corneal dystrophies. Other indications may include corneal edema, corneal trauma, corneal ulcers, and corneal degenerations. It is important to assess each patient individually to determine if they are a suitable candidate for corneal transplantation based on their specific condition and overall eye health.

Timeline

  • Before corneal transplant:
  1. Patient undergoes a comprehensive eye examination to determine the need for a corneal transplant.
  2. Indications for corneal transplantation are evaluated, with pseudophakic corneal decompensation associated with Fuch’s endothelial dystrophy being a common indication.
  3. Surgical procedure options are discussed with the patient, including penetrating keratoplasties, lamellar keratoplasties, and amniotic membrane transplant procedures.
  4. Risk factors for postoperative complications, such as transplant failure, are assessed, with previous transplant failure and comorbid Fuch’s dystrophy identified as important risk factors.
  • After corneal transplant:
  1. The surgery is carried out, with 42 corneal transplant surgeries performed on 40 eyes of 38 patients in the study period.
  2. Postoperative outcomes are monitored, with transplant failure resulting in corneal oedema or repeat corneal transplant surgery observed in 10% of cases.
  3. Intraocular lens opacification is identified as a potential complication, occurring in one lens following DSAEK, with an incidence rate of 7%.
  4. It is important to educate patients on the potential risks and complications of corneal transplant surgery, including the risk of intraocular lens opacification and its impact on vision.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with corneal transplant surgery?
  2. What is the success rate of corneal transplant surgery for my specific condition?
  3. What is the expected recovery time and postoperative care regimen?
  4. Will I need to take any medications or undergo additional treatments following the surgery?
  5. How long will the transplanted cornea last, and are there any factors that could affect its longevity?
  6. Are there any lifestyle changes or precautions I should take to protect my new cornea?
  7. What are the signs of potential complications that I should watch for after the surgery?
  8. How often will I need to follow up with you after the surgery, and what will these appointments entail?
  9. Are there any alternative treatment options to corneal transplant surgery that I should consider?
  10. Can you provide me with information about the specific type of corneal transplant procedure you recommend for my condition?

Reference

Authors: Quigley C, McElnea E, Fahy G. Journal: Ir J Med Sci. 2018 Feb;187(1):231-236. doi: 10.1007/s11845-017-1605-0. Epub 2017 May 6. PMID: 28478607