Glasses and/or contact lenses may be required to help achieve best-corrected vision after surgery. Over the course of the first year, corneal sutures are removed to help regulate corneal curvature and maximize vision. Post-operatively, eye drops are used to prevent infection and rejection, as well as to manage inflammation. Many patients will notice significant visual improvement within the first three months, although maximal visual acuity may take 6 months to 1 year to achieve. For full-thickness or Penetrating Keratoplasty (PK), the immediate healing period may be 4-6 weeks. Recovery from corneal transplantation varies based on patient age, pathology, and type of keratoplasty performed. While it is possible for the donor cornea to be rejected at any time after surgery, episodes of rejection may often be managed by topical eye drops alone. Unlike other transplant surgeries, blood type does not need to be matched, and no oral immunosuppressive medication is needed. It is the most common type of transplant surgery, and enjoys an extremely high success rate. Keratoplasty is a common procedure in the United States and is performed on an outpatient basis, often under local anesthesia. Unlike PK, DSEK is a small incision surgery requiring only one or two temporary nylon sutures used to secure the wound. The air bubble usually dissipates within the first 48 hours after surgery leaving the donor cornea in the correct position. The donor cornea is held in place with an air bubble inside the eye. In partial thickness endothelial keratoplasty (Descemet’s Stripping Endothelial Keratoplasty - DSEK), only the deep layer of the cornea containing the vitally important endothelial cells is transplanted. In full thickness or Penetrating Keratoplasty (PK) the donor cornea is “grafted” or sutured into position with fine nylon sutures. Common conditions that may require transplantation are:Ĭorneal transplantation involves removing the damaged or diseased cornea, and replacing it with a clear, healthy donor cornea. Recent surgical and technological advances have allowed partial thickness surgery such as Descemet’s Stripping Endothelial Keratoplasty (DSEK) to gain popularity as a successful alternative to full thickness transplants for conditions such as Fuch’s corneal dystrophy, and pseudophakic bullous keratopathy (PBK). Decisions regarding which procedure is required are often dependent on the depth of corneal pathology. Corneal transplantation may be either full thickness (Penetrating Keratoplasty) or partial thickness (Endothelial Keratoplasty). Surgery may be indicated due to an irregular corneal curvature that is uncorrectable with glasses or contact lenses, or when infection, scarring or swelling has caused sufficient damage to impede vision. A thorough eye examination and consultation are necessary before a treatment decision can be made.Ĭorneal transplantation, or keratoplasty, is recommended after exhausting all possible non-surgical therapies. For more extensive corneal disease, various surgical techniques such as corneal transplants, or corneal surface reshaping procedures may be required to improve or restore vision. Any one of these conditions may ultimately lead to a drop in vision.Īn improperly curved cornea, or one with mild scarring, swelling or surface irregularity may be treated medically or with a non-invasive therapy to improve the level or quality of vision. The cornea may become diseased or damaged through several different mechanisms, including hereditary corneal dystrophies, infection, inflammation, corneal edema, trauma, and keratoconus. A clear cornea with normal shape, curvature and water content is required in order for light to focus an image exactly on the retina, rather than in front of it or behind it. The cornea is the clear covering on the front of the eye which bends, or refracts, light rays that focus on the retina in the back of the eye. Corneal Transplantation for Corneal and External Eye Diseases
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