Our Summary

This study looked at changes in the types of surgery used for corneal transplants from 2005 to 2016. The research was conducted at the University Eye Hospital Tübingen where 1259 corneal transplants were performed during this period. They found that the main reasons for needing a transplant were Fuchs endothelial corneal dystrophy (a type of eye disease) and keratoconus (a condition that causes the cornea to bulge out).

The number of corneal transplants nearly doubled from an average of 71 per year in the first six years to 139 per year in the second six years. The type of surgery used also changed. Initially, penetrating keratoplasty (a procedure where the full thickness of the cornea is replaced) was commonly used. However, from 2008 onwards, the use of a procedure called Descemet membrane endothelial keratoplasty (DMEK) significantly increased. DMEK (a procedure where only the inner layer of the cornea is replaced) became the preferred method for treating conditions related to the corneal endothelium (the inner layer of the cornea), surpassing penetrating keratoplasty in 2013.

In simple terms, the study shows that over the 11 years, more people needed corneal transplants, and the way doctors performed these transplants changed. They moved from replacing the whole cornea to just replacing the inner layer, a technique that has become the go-to method for treating certain eye conditions.

FAQs

  1. What were the most common surgical indications for corneal transplantation between 2005 and 2016?
  2. How has the rate of corneal transplantations changed from 2005 to 2016?
  3. What is the current preferred surgical method for corneal endothelial dysfunction?

Doctor’s Tip

A doctor might tell a patient considering a corneal transplant that Descemet membrane endothelial keratoplasty (DMEK) has become the favored surgical method for endothelial disorders, surpassing penetrating keratoplasty. This evolution in surgical techniques has led to improved outcomes and faster recovery times for patients undergoing corneal transplantation. It is important for patients to discuss the best option for their specific condition with their doctor to determine the most suitable treatment approach.

Suitable For

Patients who may be recommended for a corneal transplant include those with Fuchs endothelial corneal dystrophy, keratoconus, and other corneal endothelial disorders. Corneal transplantation may also be considered for patients with corneal scarring, corneal ulcers, corneal degenerations, and corneal dystrophies. Additionally, patients with corneal trauma, corneal infections, and corneal thinning disorders may also benefit from a corneal transplant. The evolution of surgical methods, such as Descemet membrane endothelial keratoplasty (DMEK), has led to improved outcomes for patients with corneal disorders, making it the preferred surgical method for certain indications.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with a corneal disorder such as Fuchs endothelial corneal dystrophy or keratoconus.
  2. Patient undergoes various treatments and therapies to manage symptoms and improve vision.
  3. As the condition progresses and vision deteriorates, the patient is placed on the corneal graft waiting list.
  4. Patient undergoes pre-operative evaluations and tests to determine eligibility for corneal transplantation.

After corneal transplant:

  1. Patient undergoes corneal transplant surgery, with the type of surgery depending on the specific corneal disorder.
  2. Patient undergoes post-operative care and monitoring to ensure proper healing and integration of the donor cornea.
  3. Patient may experience temporary vision fluctuations and discomfort as the eye heals.
  4. Patient attends follow-up appointments to monitor the success of the transplant and make any necessary adjustments to medications or treatments.
  5. Patient experiences improved vision and quality of life as the transplanted cornea restores clarity and function.

What to Ask Your Doctor

  1. What is the success rate of corneal transplant surgery?
  2. What are the potential risks and complications associated with corneal transplant surgery?
  3. How long is the recovery process after corneal transplant surgery?
  4. Will I need to take immunosuppressant medications after the surgery?
  5. How long do corneal transplants typically last?
  6. Are there any lifestyle changes I need to make after the surgery to ensure the success of the transplant?
  7. How often will I need to follow up with you after the surgery?
  8. Are there any restrictions on activities or medications I should be aware of post-surgery?
  9. What are the alternatives to corneal transplant surgery for my specific condition?
  10. What is the cost of the surgery and will my insurance cover it?

Reference

Authors: Röck T, Landenberger J, Bramkamp M, Bartz-Schmidt KU, Röck D. Journal: Ann Transplant. 2017 Dec 15;22:749-754. doi: 10.12659/aot.905498. PMID: 29242495