Know all about Cornea Replacement Surgery

The cornea is the transparent outer layer of the eyeball. It serves as a window for the eye. Through the cornea, the coloured iris and pupil (the black dot in the centre of the iris) can be seen. The cornea aids in focusing light rays on the retina (the light-sensitive film at the back of the eye). This "image" is then sent to the brain. When the cornea is damaged, it loses transparency, and its shape changes. This can prevent light from reaching the retina, resulting in a distorted or unclear image transmitted to the brain. A cornea transplant is a surgical procedure that involves removing all or part of a damaged cornea and replacing it with healthy donor tissue. A cornea transplant is also known as keratoplasty or a corneal graft. It can be used to treat severe infections and damage and improve vision and relieve pain. Keratoconus, a condition that causes the cornea to change shape, is one of the most common reasons for a cornea transplant. Read on to find out more about cornea transplant surgery!

What Does Cornea Replacement Surgery Mean?

A cornea transplant (keratoplasty) is a surgical procedure that replaces a portion of your cornea with donor corneal tissue. The cornea is the clear, dome-shaped surface of your eye. It is the point at which light enters your eye and accounts for a large portion of your eye's ability to see clearly.

Why is it done?

Corneal transplants are most commonly used to restore vision in people with damaged corneas. Corneal transplants can also relieve pain and other signs and symptoms associated with corneal disease. Corneal transplants can treat many symptoms, including:

• Inflated cornea (keratoconus)
• Fuchs' dystrophy, hereditary
• Corneal thinning or laceration
• Corneal scars caused by infection or injury
• Swelling of the cornea
• Corneal ulcer that does not respond to treatment
• Complications caused by previous eye surgery

Pre-OP care

You will be subjected to the following procedures before cornea transplant surgery:

• A thorough eye examination. Your eye doctor looks for conditions that could lead to complications following surgery.
• Your eye measurements. Your eye doctor will determine the size of the donor cornea you require.
• A list of all the medications and supplements you use. Certain medications or supplements may need to be stopped before or after your cornea transplant.
• Other eye problems are treated. Unrelated eye problems, such as infection or inflammation, can lower your chances of receiving a successful cornea transplant. These issues will be addressed by your eye doctor before surgery.

Procedure

A corneal transplant removes all or part of the affected cornea and replaces it with healthy donor tissue. Determine the method used by the corneal surgeon. The steps for these types are as follows:

1. Corneal transplant (PK) is a full-thickness corneal transplant. The surgeon cuts out the entire thickness of the abnormal or diseased cornea and removes a slice of button-sized small corneal tissue. Special equipment is used for this precise circular cut. A properly adjusted donor cornea is inserted into the opening. The surgeon then uses stitches to sew a new cornea in place. Stitches can be removed later when visiting an ophthalmologist.
2. Endothelial keratoplasty (EK) - These procedures remove diseased tissue from the back corneal layers, including the endothelium and a thin layer of tissue that protects the endothelium from injury and infection (Descemet membrane). Donor tissue replaces the removed tissue. There are two types of endothelial keratoplasty. The first type, called Descemet stripping endothelial keratoplasty (DSEK), uses donor tissue to replace about one-third of the cornea. The 2nd type is called Descemet Membrane Endothelial Keratoplasty (DMEK) and uses a much thinner layer of donor tissue. The fabric used in DMEK is very thin and fragile. This method is more sophisticated and widely used than DSEK.
3. Anterior layered corneal transplant (ALK) - Two different methods remove lesion tissue from the anterior layer of the cornea, including the epithelium and stroma, but leave the posterior layer of the endothelium intact. The depth of damage to the cornea determines the type of appropriate ALK procedure. Superficial presheaf corneal transplantation (SALK) replaces only the presheaf of the cornea, leaving a healthy stroma and endothelium intact. the corneal damage extends deep into the stroma, and a deep anterior layered transplant (DALK) procedure is used. Then, healthy tissue from the donor is attached (transplanted) and the removed part is replaced.
4. Artificial corneal transplant (corneal prosthesis). In some cases, patients who are ineligible for corneal transplantation from a donor cornea may receive an artificial cornea (corneal prosthesis).

Your doctor will discuss with you which method of corneal transplantation is best for you, what you expect during surgery, and the risks of surgery.

Post-op. Care/precautions

Once the corneal transplant is complete, you can expect

• To receive the following medicines. Eye drops immediately after and during recovery from a corneal transplant and, in some cases, oral medications help control infection, swelling, and pain. Eye drops that suppress the immune system help prevent corneal rejection.
• Wear eye protection. Eye protectors or goggles protect your eyes while they heal.
• Lie on your back. Depending on the type of transplant, you may need to do this for a while after surgery to ensure that the new tissue remains in place.
• Avoid getting hurt. Plan to rest after your cornea transplant and gradually resume your normal activities, including exercise. Avoid rubbing or pressing on your eye.
• Return for regular check-ups. In the year following surgery, you should expect to see your eye doctor regularly to monitor your progress and look for complications.

If any of the symptoms mentioned above sound familiar, book an appointment with us for efficient treatment. Get premium eye care and top-of-the-range equipment with us. Opt for cornea treatment in Mauritius at Spectra. Contact us to find out more!