Our Summary

This research paper discusses recent changes in the practice of corneal transplantation based on data from the Australian Corneal Graft Registry. The paper notes that the total number of corneal transplants reported has doubled in the last ten years. There are different types of corneal transplants, and the use of some types have increased while others have decreased.

Specifically, the use of Deep Anterior Lamellar Keratoplasty (a type of corneal transplant) for treating keratoconus (a condition that causes the cornea to bulge and distort vision) has increased. Meanwhile, Endokeratoplasty (another type of corneal transplant) has become the preferred treatment for Fuchs endothelial dystrophy (a condition that causes vision loss).

The research also found that the survival rate of the transplanted cornea and the improvement in vision have both increased over time. For treating keratoconus, the first deep anterior lamellar and penetrating grafts had similar survival rates and improvement in vision. However, for Fuchs endothelial dystrophy, the penetrating grafts survived longer than endokeratoplasties, mainly because the latter had more early failures. But, the vision improved faster in successful endokeratoplasties.

Finally, the paper notes that fewer patients who received a deep anterior lamellar graft or endokeratoplasty needed glasses or contact lenses compared to those who underwent penetrating keratoplasty.

FAQs

  1. What is the trend in the practice of corneal transplantation according to the Australian Corneal Graft Registry?
  2. How do the survival rates and visual outcomes of deep anterior lamellar keratoplasty and penetrating keratoplasty compare?
  3. Do patients who undergo a deep anterior lamellar graft or endokeratoplasty require less spectacle or contact lens correction than those who undergo penetrating keratoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about corneal transplant is to follow post-operative care instructions carefully to ensure proper healing and maximize the chances of a successful outcome. This may include using prescribed eye drops, avoiding rubbing or putting pressure on the eye, and attending follow-up appointments with your doctor. Additionally, it is important to protect the eye from injury and avoid activities that could potentially harm the new cornea.

Suitable For

Patients who are typically recommended for corneal transplant include those with conditions such as keratoconus, Fuchs endothelial dystrophy, corneal scarring, corneal edema, and other corneal diseases that cannot be effectively treated with other methods. The decision to recommend a corneal transplant is based on the severity of the patient’s condition and their potential for visual improvement with the procedure. Advanced imaging techniques and diagnostic tests are used to assess the cornea and determine the best course of treatment for each individual patient.

Timeline

  • Before corneal transplant:
  1. Patient is diagnosed with a corneal disease or condition that necessitates a transplant, such as keratoconus or Fuchs endothelial dystrophy.
  2. Patient undergoes pre-operative evaluations to determine candidacy for a transplant, including eye exams and medical history assessments.
  3. Patient is placed on a waiting list for a suitable donor cornea.
  4. Once a donor cornea becomes available, patient undergoes surgery for the corneal transplant.
  5. Patient undergoes post-operative care, including follow-up appointments and medication regimen to prevent rejection of the transplant.
  • After corneal transplant:
  1. Patient experiences initial discomfort and blurred vision following surgery.
  2. Patient’s vision gradually improves over time as the transplanted cornea heals and integrates with the eye.
  3. Patient undergoes regular follow-up appointments to monitor the success of the transplant and address any complications or issues.
  4. Patient may require adjustments to their medication regimen to prevent rejection or infection.
  5. Patient experiences improved vision and quality of life as the transplant successfully restores vision and function to the affected eye.

What to Ask Your Doctor

  1. What is the reason for needing a corneal transplant?
  2. What are the different types of corneal transplant procedures available?
  3. What are the potential risks and complications associated with a corneal transplant?
  4. What is the success rate of the specific type of corneal transplant recommended for my condition?
  5. What is the recovery process like after a corneal transplant?
  6. How long will it take to regain vision after the surgery?
  7. Will I need to take any medications or follow a specific post-operative care regimen?
  8. How often will I need to follow-up with my doctor after the surgery?
  9. What are the potential long-term effects of a corneal transplant?
  10. Are there any restrictions on activities or lifestyle changes I should be aware of after the surgery?

Reference

Authors: Williams KA, Keane MC. Journal: Clin Exp Ophthalmol. 2022 May;50(4):374-385. doi: 10.1111/ceo.14089. Epub 2022 May 17. PMID: 35488434