What is corneal transplant ?

Corneal transplant is a type of surgery where a diseased or damaged cornea is transplanted with a new one, usually donated corneal tissue. This procedure is required in cases where other treatment methods are not effective in correcting vision or if medications or special contact lenses do not relieve the painful swelling.

The cornea is the transparent tissue present on the front of the eyes.

The main function of the cornea is to focus light rays onto the retina (the innermost layer of the eye). If the cornea is not clear or damaged it causes blurring of vision, watering of the eyes and other such conditions.

Corneal Transplant has the most success rate compared to other transplant surgeries such as heart, lungs, kidneys, etc. The entire surgery is done under an Operating microscope.

When is it needed?

There are certain conditions of the eye that cannot be treated using other treatment methods and this is when doctors recommend a corneal transplant. Some of these conditions are as follows:

• Corneal failure after eye surgery
• Keratoconus
• Hereditary corneal failure
• Corneal dystrophies
• Scarring after infections
• Rejection after the first corneal transplant.

What corneal surgeon do ?

• At first, a local or general anesthesia is given to the patient. The surgeon decides the dosage according to the age, general health and anxiety level of the patient, as well as, the period of the surgery.
• The whole surgical procedure is performed under an operating microscope. Trephine, which is a circular cutter-like instrument, is used to discard the damaged or diseased cornea from the eye.
• The surgeon will cut out the ‘button’ from the donor cornea, after which the donor cornea is stitched onto the eye with extremely fine nylon sutures. A patch and a shield are applied to protect the eye.

Post Surgery

• Eye drops are provided that are essential and must be used as prescribed by your doctor.
• Eye injury must be avoided at all costs. Sports such as cricket, badminton, etc., are discouraged right after a corneal transplant. Other daily activities can be resumed after a few days of recovery.
• In order to prevent the new cornea from being rejected, steroid eye drops are used for several months after surgery. These eye drops do not cause side effects as compared to oral steroids.
• Symptoms such as excessive redness of the eye, sensitivity to light, vision loss or pain in the eye along with flashes, floaters, and loss of peripheral vision must be reported immediately to the doctor.

New Corneal Transplantation Method

• DSEK: Descemet Stripping Endothelial Keratoplasty is a method in which a small amount of the posterior layer of the cornea and the innermost part of the cornea is transplanted to a decompensated cornea for diseases such as pseudophakic/aphakic corneal decompensation, Fuchs endothelial dystrophy, and other disorders in which the endothelium does not function. The lack of sutures causes faster visual recovery and astigmatism is lesser.
• DALK: Deep Anterior Lamellar Keratoplasty is the transplantation of the top and middle layers of the cornea. It is used for keratoconus and other corneal diseases involving the top and middle layers of the cornea. Minimal chance of corneal endothelial rejection is noted.