Corneal Transplant: Definition, Types, Symptoms, Risk Factors, Procedure, and More

Corneal-Transplantation

Corneal transplant is like a medical superhero, saving lives by replacing damaged organs with healthy ones from donors. One special type of transplant is the corneal transplant which doesn’t just save lives but also brings back the gift of sight. In this article, let’s explore the importance and details of corneal transplantation in simpler terms. For more research you can also visit Medical News Today.

What is the Corneal Transplant?

Corneal transplant is a medical procedure where a sick or failing organ is swapped with a healthy one from someone else. This incredible treatment gives hope to people suffering from severe organ problems, like heart, kidneys, liver, lungs, or pancreas issues. The cornea is a clear part of the eye that helps focus light, allowing us to see. Corneal disease is a major cause of blindness worldwide. In 2014, over 47,000 people in the United States underwent corneal transplant surgery. This article explains why people might need a corneal transplant, the types of surgery available and what to expect during the procedure.

Why Do I Need a Corneal Transplant?

A corneal transplant can urgently improve or restore vision if you have a damaged or diseased cornea. It may be used to treat conditions such as:

  • Fuchs’ Dystrophy: A degeneration of the innermost layer of the cornea.
  • Keratoconus: A condition where the cornea bulges outward.
  • Lattice Dystrophy: A type of corneal degeneration.
  • Thinning of the cornea.
  • Corneal scarring, clouding, or swelling.
  • Corneal Ulcers: Often caused by trauma, such as a scratched cornea.

What are the Types of Corneal Transplant?

There are different types of corneal transplant depending on which part of the cornea is damaged and how severe the damage. The cornea has five layers:

  • Epithelium: The outer layer that protects the cornea and helps focus light.
  • Bowman’s layer: A thin layer between the epithelium and the stroma.
  • Stroma: This layer gives the cornea its strength.
  • Descemet’s membrane: A thin layer between the stroma and the endothelium.
  • Endothelium: The innermost layer that acts like a pump to remove fluid from the cornea.

Key things to know about corneal transplants:

  • Whole Eyes Transplant (PK):
  • This type replaces the whole damaged cornea with a donor cornea.
  • Part Eye Transplant (DSEK & DMEK):
  • These focus on fixing specific inner layers of the cornea.

Donor Cornea:

Health corneas come from people who agreed to donate their eyes after they pass away. Special eye banks and get these corneas ready for surgery.

Surgery Steps:

Eye doctors called eye surgeons, do corneal transplants. They take out the damaged cornea during surgery and put in the donor cornea with stitches or glue.

Getting Better after Surgery:

After the surgery people need time to heal and follow the doctor’s instructions. Sometimes, they may also need help learning how to see better again.

Full Thickness Corneal Transplantation:

A corneal transplantation  is an operation to replace part of the cornea with corneal tissue from a donor. This operation is sometimes called keratoplasty. The cornea is the transparent, domed shaped surface of the eye. Light enters the eye through the cornea. It plays a large role in the eye’s ability to see clearly. A cornea transplant may:

  • Restore vision
  • Reduce pain
  • Improve the appearance of a damaged or diseased cornea.

Most cornea transplant operations are successful. But cornea transplant carries a small risk of complications, such as the rejection of the donor cornea.

Anatomy of the Eye:

A cornea transplant is most often used to restore vision to a person with a damaged cornea. A cornea transplant also can relieve pain or other symptoms associated with cornea diseases. A number of conditions can be treated with a cornea transplant including;

  • A cornea that bulges outward called keratoconus
  • Fuchs dystrophy a genetic condition
  • Cornea scarring caused by infection or injury
  • Swelling of the cornea
  • Corneal ulcer not responding to medical treatment
  • Complications caused by previous eye surgery

What are the Symptoms of Corneal Transplant?

The body’s immune system can mistakenly attack the donor cornea. This is called rejection. Rejection might require medical treatment or another cornea transplant. Make an urgent appointment with your eye doctor if you notice symptoms of rejection such as:

  • Loss of vision
  • Eye pain
  • Red eyes
  • Sensitivity to light

What are the Risk Factors of Corneal Transplant?

Cornea transplant is relatively safe. Still it does carry a small risk of serious complications, Such as:

  • Eyes infections
  • Pressure increase within the eyeball, called glaucoma
  • Problems with the stitches used to secure the donor cornea
  • Rejection of the donor cornea
  • Bleeding
  • Retinal problems such as retinal detachment or swelling

How Do I Prepare for a Corneal Transplant?

Before corneal transplants surgery you will undergo:

A Thorough Eye Exam:

Your eye doctor looks for conditions that might cause complications after surgery.

Measurements of Your Eye:

Your eye doctor determines what size donor cornea you need.

A Review of all Medications & Symptoms:

You may need to stop taking certain medications or supplements before or after your cornea transplant.

Treatment for other Eye Problem:

Unrelated eye problems such as infection or swelling can reduce your chances of a successful cornea transplant. Your eye doctor will treat those problems before your surgery.

Operations to Transplant a Portion of the Cornea:

A cornea transplant removed either the entire thickness or the partial thickness of the disease cornea and replaced it with healthy donor tissue. Your cornea surgeon will decide which method to use. These types of operations include:

  • Penetrating keratoplasty
  • Endothelial keratoplasty
  • Anterior lamellar keratoplasty
  • Artificial cornea transplant

Before the day of your surgery, ask your doctor for specific preparation instructions for your procedure. These may include:

  • Avoid eating and drinking after midnight on the night before surgery
  • Wearing loose, comfortable clothing on the day of the procedure
  • Keeping your face free of makeup, creams, lotions, and jewelry
  • Arranging for someone to drive you home after the procedure

What You Can Expect About Corneal Transplant?

During the Procedure:

On the day of your cornea transplant you’ll be given a medicine to help you feel calm or less anxious or a medicine that numbs your eyes. Either way, you shouldn’t feel the pain. Surgery is done on one eye at a time. The amount of time spent in surgery depends on your situation.

After the Procedure:

After your cornea transplant, you can expect to:

  • Receive medicines
  • Wear eye protections
  • Lie on your back
  • Avoid injury
  • Return for frequent follow-up exams

What Happens After a Corneal Transplant?

You will be discharged on the same day as your surgery. Expect some soreness, and you’ll likely wear an eye patch or gauze over the operated eye for up to four days. Avoid rubbing your eyes. Your doctor will prescribe eye drop and possibly oral medications to aid healing and prevent rejection or infection. Seek medical attention immediately if you experience any of these symptoms:

Vision Correction after Surgery:

At first your vision might be worse than it was before your surgery. Your eye needs time to adjust to the new cornea. It can take several months for your vision to improve. It takes several weeks to several months after surgery for the outer layer of your cornea to heal. When it heals your eye doctor will make adjustments that can improve your vision, such as:

Correcting Unevenness in Your Cornea:

These stitches that hold the donor cornea in place on your eye might cause irregularities in your cornea. This uneven surface can cause astigmatism. Astigmatism can make your vision blurry. Because your eye doctor might address the astigmatism by releasing some stitches.

Correcting Vision Problems:

Refractive errors, such as nearsightedness and farsightedness, can be corrected. So your eye doctor may recommend glasses, contact lenses, or in some cases laser eye surgery.

What’s the Cost of Corneal Transplant?

According to a report by the Healthcare Costs and Utilization Project (HCUP), in 2007 the average cost of an outpatient corneal transplant procedure was $113,119. For the latest costs and figures consult with a doctor or surgeon. Costs may vary according to:

  • The state or hospital where the procedure occurs
  • The type of health insurance a person has
  • The doctor who performs the surgery

Most people who receive a cornea transplant will have their vision at least partially restored. What you can expect after your corneal transplants depends on your health and the reason for your surgery. Your risk of complications and cornea rejection continues for years after your cornea transplant. For this reason, see your eye doctor yearly. Cornea rejection can often be managed with the medications.

What to Know About Corneal Edema?

Overview:

Corneal edema is when the clear outer surfaces of the eye, called the cornea, swells due to fluid buildup. If not treated, it can cause cloudy vision.

What are the Causes of Corneal Edema?

The cornea is made up of layers of tissues that help focus light on the back of the eye for clear vision. Along the inner surface of the cornea is a layer of cells called the endothelium. Its role is to remove any fluid that builds up inside the eye. When endothelium cells are damaged, fluid accumulates, causing the cornea to swell and vision to become cloudy. Endothelium cells cannot regenerate once damaged. Diseases that damaged endothelium cells and may lead to corneal edema include:

  • Fuchs’ endothelial dystrophy is an inherited disease that gradually destroys endothelial cells.
  • Endotheliitis, an immune response that causes inflammation of the endothelium due to the herpes virus.
  • Glaucoma, a condition where pressure builds up inside the eye, which can sometimes damage the optic nerve and lead to corneal edema, although this is rare.
  • Posterior polymorphous corneal dystrophy, a rare inherited condition affecting the cornea.
  • Chandler’s syndrome, a rare disorder where epithelial cells multiply too quickly.
  • Cataract surgery can also harm endothelial cells, sometimes leading to corneal edema. This is less common today due to improvements in lens design.

Certain drugs can increase the risk of corneal edema:

  • Benzalkonium chloride, a preservative found in many eye drops and anesthetic drugs.
  • Chlorhexidine (Betasept, Hibiclens), an antiseptic used before surgery to disinfect the skin.
  • Amantadine (Gocovri), a drug used to treat viruses and Parkinson’s disease.

What are the Symptoms of Corneal Edema?

As the cornea swells and fluids build up, your vision will become blurry or cloudy. You might notice that your vision is especially hazy when you first wake up in the morning but it improves throughout the day. Other symptoms of corneal edema include:

  • Halos around lights
  • Eye pain
  • The feeling that a foreign object is in your eye

What are the Treatment of Corneal Edema?

If corneal edema is mild treatment may not be necessary. Your eye doctor might suggest using concentrated saline (salt-and-water) drops or ointment to temporarily reduce swelling in the eyes. If swelling occurs overnight you can ask your doctor if it’s safe to gently blow air into your eyes with a hair dryer in the morning to help evaporate the excess tears. Hold the hair dryer at arm’s length to avoid injuring your eye. However, if the swelling becomes severe and affects your vision, surgery may be necessary. Surgical procedures used to treat corneal edema include:

Penetrating Keratoplasty (PK or PKP):

During the surgery, the surgeon removes all layers of your cornea and replaces them with healthy tissue from a donor. The new corneal tissue is secured in place with sutures. After this procedure you may need to wear corrective lenses to achieve clear vision, especially if the graft is irregularly shaped. Potential risks associated with this surgery include damage to the lens of the eye, bleeding, glaucoma, or rejection of the graft by the body.

Descemet’s Stripping Endothelial Keratoplasty (DSEK):

This procedure replaces only the damaged endothelial layer of your cornea, leaving the rest intact. Both the procedure and the recovery are faster than with a full corneal transplant.

What is the Healing and Recovery Time of Corneal Edema?

Your recovery time depends on how severe your corneal edema is and how it’s treated. Mild corneal edema might not cause any symptoms or require treatment. If you undergo surgery to replace your entire cornea, it could take a year or longer to fully restore your vision. Because the new cornea may have an irregular shape, you may need to wear glasses to achieve clear vision. Healing is much faster after a DSEK procedure which removes only part of your cornea.

FAQs:

Why are cornea transplants so successful?

It is the most successful organ transplantation in the human body as the cornea is devoid of vasculature, minimizing the risk of graft rejection.

Can cornea repair itself?

As with many other body tissues the cornea has an inherent ability to repair itself after incurring damage. Though in more severe cases it may not be able to do so. In such scenarios, professional treatment may be necessary to effectively restore your eye health and fitness visual acuity.

Which country is best for cornea transplantation?

The following countries have the best corneal transplant. Such as:

  • Mexico
  • India
  • Thailand
  • Singapore
  • United states

Can a blind person see after corneal transplantation?

People have gone from being almost fully visually impaired to having perfect to near-perfect eyesight right after the operation. Not all cases are as successful, of course, but younger patients in particular will get to view life with new eyes post-surgery.

Can a damaged cornea be healed?

How are corneal abrasions treated? In people who are in good general health most typical corneal abrasions can heal on their own within 24 to 48 hours. A doctor may prescribe antibiotic eye drop or ointment. Because the cornea is so sensitive, simply opening and closing the eyes over the abrasions may be painful.

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