A cornea transplant is one of the most important eye surgeries as it has the potential to change the lives of thousands of people suffering from corneal issues. For instance, Fuchs’ dystrophy and keratoconus are widespread and many people are impacted and live a compromised lifestyle due to the vision problems they experience. So, when they go for a cornea transplant and it works, their lives change for the better. So, let’s dive into the mysteries behind cornea transplants and how it works.
What is Cornea Transplant?
Before we learn how cornea transplant works, it is important to know what it is.
A cornea transplant, a.k.a. corneal grafting or keratoplasty, is a popular surgical procedure that aims to replace the cornea, which is the transparent front layer of the eye. In most cases, an eye care provider suggests this surgery if your cornea is damaged, which can lead to eye pain, cloudy vision, and blurred vision.
During the procedure, the surgeon takes out the damaged cornea and replaces it with healthy corneal tissue from a donor. For many individuals, a cornea transplant helps restore vision and significantly enhances their quality of life.
What are the Different Types of Corneal Transplants
Corneal transplants are of different types and chosen based on their suitability for a specific patient. Let’s have a look at some popular corneal transplants that are mainly used:
There are three main types of corneal transplants, depending on which part of the cornea is affected:
- Full-thickness corneal transplant a.k.a. Penetrating Keratoplasty (PK):
In this transplant, the eye surgeon replaces the entire thickness of the cornea. It’s used when the entire cornea is damaged in cases like advanced keratoconus, scarring, or a severe corneal disease. In this transplant, the central portion of the damaged cornea is replaced with a full-thickness donor cornea.
- Outer corneal layers transplant a.k.a. Anterior Lamellar Keratoplasty (ALK):
In this type, only the front layers (the outer, anterior part) of the cornea are replaced. This type of transplant is used when damage is confined to the outer portion of the cornea, for instance, in early keratoconus or superficial scarring. There are two types of ALK:
- Superficial Anterior Lamellar Keratoplasty (SALK)
- Deep Anterior Lamellar Keratoplasty (DALK)
- Inner corneal layers transplant a.k.a. Endothelial Keratoplasty (EK)
This type of transplant is used when only the innermost layer of the cornea is damaged. It is a common condition that is seen in eye diseases like Fuchs’ dystrophy or corneal edema. The two main types of EK are:
- Descemet’s Stripping Endothelial Keratoplasty (DSEK or DSAEK)
- Descemet’s Membrane Endothelial Keratoplasty (DMEK)
How Does a Cornea Transplant Work?
A cornea transplant is a process involving many steps. It works by replacing the damaged or diseased cornea with healthy donor tissue. In most cases, it restores vision and enhances eye function. So, let’s have a look at how the process normally works:
Before the surgery takes place, the surgeon numbs the eye using local anaesthesia. Sometimes general anaesthesia is used to ensure comfort. After that, the surgeon then uses a special instrument to measure and prepare the donor cornea, ensuring it is a precise match for the patient.
The surgeon then moves on to the second step, which is carefully removing the damaged or diseased portion of the cornea. In most cases, it is the central section. In most surgeries, this process involves the use of a circular cutting tool called a trephine. This tool is known to create a clean, round cut in the cornea, which is essential for a successful surgery.
After that, the healthy donor corneal tissue, cut to fit the patient’s eye, is carefully positioned in place. It may be a full-thickness graft or just a partial-thickness graft. The type of graft that is taken out completely depends on the type of corneal damage.
The surgeon then stitches or uses a special adhesive to secure the donor tissue to the eye. After that, fine sutures are used to hold the new cornea in the designated position. The sutures are typically removed once the eye has healed, which normally happens after several months.
After the surgery is complete, the eye is covered with a protective shield or bandage. Most patients are given eye drops and medications to prevent infection, reduce inflammation, and promote healing. The recovery process can take several months. In the recovery period, the patients will need to attend follow-up appointments to monitor healing.
For many people, a cornea transplant significantly enhances their vision. However, it may take some time for the vision to completely stabilize as the eye heals. In some instances, glasses or contact lenses may still be needed to correct vision.
A successful cornea transplant can restore vision. I can also lower the pain level, and enhance the overall health and how the eye looks.
Final Thoughts
A cornea transplant is a life-changing surgery that has the potential to change the lives of patients for the better. When performed by adept surgeons like A/Prof Samarawickrama, the chances of successful outcomes increase greatly. A good surgeon can suggest you the best treatment option and recovery plan, which can help you restore your vision and live life happily.