Our Summary

Keratoconus is an eye condition that can lead to reduced vision and scarring on the cornea, the clear front surface of the eye. In severe cases, it may require a corneal transplant. Corneal cross-linking (CXL) is a newer treatment that might help prevent the need for such transplants. This study looked at data from the Dutch National Organ Transplant Registry to see if the introduction of CXL has reduced the number of corneal transplants performed annually. Researchers compared the number of transplants done before and after CXL was introduced. They found that about 25% fewer corneal transplants were done in the three years after CXL was introduced compared to the three years before. This suggests that CXL can significantly reduce the need for corneal transplants in patients with keratoconus.

FAQs

  1. What is Keratoconus and how can it affect vision?
  2. What is corneal cross-linking (CXL) and how does it help in treating Keratoconus?
  3. Has the introduction of CXL reduced the number of corneal transplants performed annually?

Doctor’s Tip

A doctor might advise a patient considering a corneal transplant to first explore options like corneal cross-linking (CXL) to potentially prevent the need for a transplant. CXL has been shown to reduce the number of corneal transplants performed annually in patients with keratoconus. It is important to discuss all treatment options with your doctor to determine the best course of action for your specific condition.

Suitable For

Patients with keratoconus, a condition that causes the cornea to thin and bulge outwards, are typically recommended for corneal transplant surgery if their vision is significantly impaired and other treatments have not been effective. Other conditions that may warrant a corneal transplant include corneal scarring from injury or infection, corneal dystrophies, and corneal degeneration. Ultimately, the decision to undergo a corneal transplant is made on a case-by-case basis by an ophthalmologist after considering the patient’s individual circumstances and medical history.

Timeline

Before corneal transplant:

  1. Patient experiences symptoms of keratoconus such as blurred vision, sensitivity to light, and frequent changes in prescription glasses or contact lenses.
  2. Patient undergoes various treatments such as rigid gas permeable contact lenses, intracorneal ring segments, and corneal collagen cross-linking (CXL) to try to improve vision and delay the need for a transplant.
  3. As the condition progresses and vision continues to deteriorate, the patient is evaluated by an ophthalmologist who recommends a corneal transplant as the best treatment option.

After corneal transplant:

  1. Patient undergoes pre-operative evaluations and tests to determine the best match for a donor cornea.
  2. Corneal transplant surgery is performed, where the damaged cornea is replaced with a healthy donor cornea.
  3. Patient undergoes post-operative care and follow-up appointments to monitor healing and ensure the success of the transplant.
  4. Patient may experience temporary blurred vision, light sensitivity, and discomfort during the recovery period.
  5. Over time, the new cornea integrates with the eye, and the patient’s vision gradually improves.
  6. Patient may still require prescription glasses or contact lenses to achieve the best vision possible after the transplant.

What to Ask Your Doctor

  1. Is a corneal transplant the best treatment option for my keratoconus?
  2. What are the risks and potential complications of a corneal transplant?
  3. How long is the recovery period after a corneal transplant?
  4. What are the success rates of corneal transplants for patients with keratoconus?
  5. Are there any alternative treatments, such as corneal cross-linking, that may be effective for my condition?
  6. How will my vision be affected after a corneal transplant?
  7. What is the long-term outlook for my vision and eye health after a corneal transplant?
  8. How often will I need to follow up with you after the transplant surgery?
  9. Are there any lifestyle changes I should make to improve the success of the corneal transplant?
  10. Are there any specific medications I will need to take before or after the transplant surgery?

Reference

Authors: Godefrooij DA, Gans R, Imhof SM, Wisse RP. Journal: Acta Ophthalmol. 2016 Nov;94(7):675-678. doi: 10.1111/aos.13095. Epub 2016 May 23. PMID: 27213687