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Corneal Transplant Surgery

Corneal transplant surgery is a sophisticated procedure employed to replace damaged or unhealthy corneal tissue with healthy ones from a donor. This surgery improves vision and alleviates discomfort caused by various corneal conditions. By understanding the different types of corneal transplant surgeries, their recovery process, and their success rates, you can make an informed decision about your treatment options. If you suspect you may need this surgery, or for further enquiries, don't hesitate to consult the experienced doctors at Pristyn Care for a diagnosis or book your appointment today.

Corneal transplant surgery is a sophisticated procedure employed to replace damaged or unhealthy ... Read More

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What is Corneal Transplant Surgery?

Corneal transplant surgery, also known as corneal grafting or keratoplasty, is a surgical procedure designed to treat various corneal conditions that affect vision and cause discomfort. The cornea is the clear front layer of our eyes that focuses light to provide us with clear vision. When damaged or diseased by conditions such as keratoconus, Fuchs’ dystrophy, or corneal scarring, this crucial part of the eye can be replaced with healthy tissue from a donor. The operation is normally carried out by an eye specialist (ophthalmologist) on an OPD basis, which means there’s usually no need for an overnight hospital stay. Despite its complexity, corneal transplant surgery enjoys a high success rate and has become a common solution for severe corneal issues.

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What Are The Types Of Corneal Transplant Surgery?

Corneal transplant surgeries come in different types based on the layers of the cornea that need replacement. Here are the key types:

  • Full-thickness (Penetrating) Keratoplasty: Also known as PK, this method involves removing a circular section of the whole cornea and replacing it with a healthy donor cornea. It’s often used for conditions affecting multiple layers of the cornea like severe scarring or disease.
  • Endothelial Transplants: These target the back layers of the cornea, specifically treating diseases such as Fuchs’ dystrophy and bullous keratopathy. Techniques include Descemet’s Stripping Endothelial Keratoplasty (DSEK) and Descemet Membrane Endothelial Keratoplasty (DMEK). Both types involve replacing the inner lining along with some supporting tissue and typically have quicker recovery times than full-thickness transplants.
  • Deep Anterior Lamellar Keratoplasty (DALK): DALK is a partial thickness corneal transplant that involves replacing the outer and middle layers of the cornea, while preserving the innermost endothelial layer. This technique is especially useful for treating conditions such as keratoconus or anterior stromal scars, as it minimizes the risk of graft rejection.

Keratoprosthesis: This specialised type of corneal transplant combines donor corneal tissue with a synthetic central optic. It’s typically reserved for patients with severe corneal disease who are unlikely to benefit from traditional corneal transplants.

Diagnosis Before Corneal Transplant Surgery

Before heading towards corneal transplant surgery, it’s crucial to have a comprehensive evaluation of the patient’s eyes. The diagnosis of keratoconus may require several tests and examinations including:

  • Medical History and Eye Exam: The process begins with a thorough review of the patient’s medical history and family history. An eye examination to assess vision and look for signs of eye conditions is also conducted.
  • Corneal Topography: This diagnostic tool creates a detailed map of the cornea’s surface curvature. This allows the identification of any irregularities characteristic of keratoconus.
  • Slit-Lamp Examination: A specialised microscope is used to closely examine the cornea for signs such as Fleischer rings and Vogt striae, which are indicative of keratoconus.
  • Pachymetry: This test measures the thickness of the cornea, identifying areas of thinning common in keratoconus patients.

Once diagnosed, if keratoconus progresses to a stage where vision cannot be adequately corrected with glasses or contact lenses, corneal transplant surgery may be deemed necessary.

What Is The Procedure For Corneal Transplant Surgery?

Corneal transplant surgery is an outpatient procedure designed to replace damaged or diseased cornea with healthy donor tissue. Here’s what you can expect from the procedure:

  • Preparation: The procedure is usually performed under general anaesthesia, so you’ll be asleep and won’t feel any discomfort.
  • Surgical Procedure: The surgeon removes the central part of your abnormal cornea and replaces it with a donor cornea (corneal graft). The donor tissue is carefully cut to ensure a perfect fit using either laser techniques or traditional microsurgery methods.
  • Securing the Graft: The new cornea is then carefully stitched in place. These stitches may remain for several months to a year, depending on your healing process.
  • Postoperative Care: After surgery, you will need to take some time off work for recovery and must attend regular follow-up appointments to monitor healing and visual improvement.

The corneal transplant surgery success rate is high, with most patients experiencing significant improvements in vision.

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Who Is The Right Candidate For Corneal Transplant Surgery?

Determining if you’re a suitable candidate for corneal transplant surgery depends on various factors. Here are a few conditions that might make you eligible:

  • Vision Quality: If your vision cannot be adequately corrected with glasses or contact lenses, you might be a candidate for corneal transplant surgery.
  • Severity of Keratoconus: If diagnosis shows that keratoconus has progressed to a stage that impacts your daily life significantly, corneal transplant surgery may be necessary.

Other Treatments’ Ineffectiveness: If other treatments have failed to improve your vision or alleviate your symptoms, corneal transplant surgery could be the next step.

What Are The Benefits Of Corneal Transplant Surgery?

Corneal transplant surgery can be a transformative procedure for those suffering from corneal diseases. The benefits of this surgery are manifold:

  • Improved Vision: A high proportion of patients report substantial improvements in their visual acuity following the procedure. In fact, within a year post-surgery, many achieve driving-standard vision.
  • Symptom Relief: Corneal transplant surgery alleviates symptoms like blurry vision, eye pain, and light sensitivity, contributing to an improved quality of life.
  • High Success Rate: With good postoperative care, corneal transplant surgery has a high success rate. Many patients enjoy lasting improvements in vision and corneal functionality.

Reduced Pain: For patients with painful corneal conditions, the transplant can relieve the discomfort associated with corneal diseases.

How To Prepare For Corneal Transplant Surgery?

Before you undergo corneal transplant surgery, there are several preparations you must make. Here are some key steps:

  • Preoperative Assessment: This involves a thorough eye examination and review of your medical history to ensure you’re a suitable candidate.
  • Medications: You may be prescribed medications to manage any underlying conditions and prevent infection.
  • Avoiding Certain Medications: It’s essential to avoid blood thinners or anti-inflammatory medications before the surgery as advised by the surgeon.

Logistics: Arrange transportation to and from the hospital, as you will not be able to drive after the operation due to the effects of general anaesthesia.

What Are The Recovery Tips and Precautions To Follow After Corneal Transplant Surgery?

Postoperative care is paramount for recovery after corneal transplant surgery. Here’s what you should look out for:

  • Follow-Up Appointments: Regular visits to the ophthalmologist are necessary to monitor healing and early detection of any complications.
  • Medications: Be diligent in taking prescribed eye drops (antibiotics and corticosteroids) to reduce inflammation and prevent infection.
  • Activity Restrictions: Avoid strenuous activities, swimming, or rubbing the eyes for several weeks post-surgery to protect the graft.

Protective Eyewear: Wear sunglasses outdoors to shield the eyes from UV light and wind.

Potential Risks Or Complications Associated With Corneal Transplant Surgery

Despite its high success rate, corneal transplant surgery does come with potential risks. Here are some complications that might occur:

  • Graft Rejection: There is a chance that the body may reject the donor tissue, which can lead to vision loss if not promptly addressed. Symptoms include redness, pain, or sudden changes in vision.
  • Infection: Though rare, postoperative infections can occur and these can affect the healing process and ultimate success of the graft.
  • Astigmatism: As a result of changes in the corneal shape following surgery, astigmatism can occur, potentially necessitating corrective lenses or additional procedures.

Vision Fluctuations: During the healing process, patients may experience fluctuations in their vision as the eye adjusts to the new graft.

FAQs

How is corneal transplant surgery diagnosed?

Your ophthalmologist or eye specialist will use certain tools and tests to diagnose the conditions requiring corneal transplant surgery. These may include a slit-lamp examination, computerised corneal mapping, measure of corneal thickness (pachymetry), assessment of endothelial cell density and other necessary checks to evaluate the condition of your corneal layers.

What is the success rate of corneal transplant surgery in India?

Corneal transplant surgeries have a high success rate globally and in India. The exact success rate might vary depending on the specific type of surgery performed. On average, more than 95% of patients experience significant improvement in their vision after corneal transplant surgery.

How long does it take to recover from corneal transplant surgery?

Recovery from a corneal transplant surgery varies from person to person and also depends on the type of transplant done. Typically, complete healing for full-thickness transplants might take up to 12-18 months, while recovery from partial thickness or anterior lamellar transplants (DALK) can be faster.

How will my vision change after corneal transplant surgery?

Post-corneal transplant surgery, you may notice a significant improvement in your vision. However, it’s important to note that this improvement may not be immediate. For some, it could take several months before they experience a noticeable enhancement in sight.

What can I do to increase the chances of successful recovery post-corneal transplant surgery?

Maintaining regular follow-ups with your specialist, adhering strictly to your prescribed medication routine, protecting your eyes from injury, and avoiding strenuous activities can significantly enhance your recovery process and increase the chances of a successful outcome post-surgery.

Can I lead a normal life after corneal transplant surgery?

Yes, the majority of individuals who undergo corneal transplant surgery can resume their standard activities after a complete recovery period. However, certain precautions, like wearing protective eyewear during sports and avoiding eye rubbing, need to be followed.

How often should I visit my doctor after corneal transplant surgery?

During your recovery from corneal transplant surgery, it’s vital to maintain regular visits with your doctor to monitor the healing process. The frequency of these check-ups might be weekly initially, then monthly and eventually yearly as per your doctor’s recommendation.

Can a corneal transplant surgery be repeated if needed?

In some cases, if the initial corneal transplant fails or if the eye condition recurs, a second or even third transplant may be performed. The success of repeat procedures, however, depends on the specific circumstances and the cause of the original graft failure.

Is corneal transplant surgery painful?

Corneal transplant surgery is generally performed under local anaesthesia, meaning you will be awake but your eye will be numbed. You should not feel pain during the procedure. After the operation, you might experience some discomfort or mild pain which can usually be managed with medication.

What are the signs that indicate a successful corneal transplant surgery?

Successful corneal transplant surgery is generally indicated by improved clarity of vision, absence of redness or pain in the eye, and lack of rejection symptoms such as sensitivity to light and reduced vision.

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