Corneal transplantation

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Overview

Our eyes are two very smart, small organs, localized on the face. They can process 36,000 bits of information every hour and have over 2 million parts that work together.

Sometimes even the eyes, specifically the cornea degrades and is necessary to replace it with transplantation. Of all types of transplantation, corneal transplantation isn’t most often performed but is most successful.


Contents

1. Overview
2. The cornea
3. Candidate for a cornea transplant
4. The procedure and recovery
5. Risks
6. Signs and symptoms of corneal rejection
7. Vision correction following the surgery


The cornea

The cornea is the peripheral layer of the eye, that clear surface covering the iris and pupil round the eye color of a person. The cornea has a purpose to focus light entering the eye so to be clear.

To do this effectively, the cornea must be clear and transparent. This is dome-shaped is a group of proteins and cells with a few millimeters thick. Sometimes corneal might scarring, is affected by illness and decay, it distorts the light and in certain areas of the eye occurs blindness or blurred vision.

To correct this, an ophthalmologist may suggest wearing special glasses or contact lenses, and medications to alleviate pain caused by inflammation. If none of these treatment methods works, the next step could be a cornea transplant surgery.


Candidate for a cornea transplant

If you experience corneal opacity after cataract surgery, if you have an eye scar resulting from an accident or scratch the eye, if the eye is present bacteria or fungi as a result of wearing inadequate eye contact lens or if a person rejected previous corneal tissue from a donor, you are candidate for a corneal transplant.

Basically if the person view can’t be corrected by other non-surgical method, transplantation may be the next alternative.


The procedure and recovery

Person to support corneal transplant surgery will receive local or general anesthesia, depending on age, overall health and level of involvement of the eye. This procedure can be done outpatient.

There are several types of surgery that can make corneal transplantation. Most common performed is the penetrating keratoplasty that involves completely removing opacified cornea.

The doctor will cut the center of the diseased cornea and the donor cornea is placed in its place; it is sutured with stitches that will remain in the eye until the eye is healed. After surgery your ophthalmologist will recommend the use of antibiotic drops to ensure that there will be no infection in the operated eye.

Sometimes you have to replace only part of the cornea. Instead of completely eliminating the cornea, doctors remove the diseased endothelial cells and replace them with healthy endothelial tissue to reconstruct the cornea. This type of surgical procedure is called endothelial keratoplasty.

When corneal disease only affects the front of the eye, will be required deep lamellar anterior keratoplasty method that involves removing only the front part of the eye and replace it with some donated corneal tissue.

After surgery and recovery, patients won’t drive the car. The next day they return to consultation, the doctor who will decide when the stiches are removed. Sometimes they can be removed in a year or can be left permanently in the eye.

Corneal transplants are safe, but complications can occur which may include eye infections, cataracts, glaucoma, trouble shots, inflammation and corneal transplant rejection. Rejection refers to the immune system mistakenly attacks the donor cornea.

About 20% of patients experience this problem. Signs of rejection include pain, loss of vision, redness, sensitivity to light. Detected early, problems can be solved.

After recovery, the view might be worse than it was before, but will improve as the eye adjusts to the new cornea. This is normal, so do not be alarmed. The healing process may last from several weeks to several months.


Risks

Corneal transplantation is a pretty safe procedure. But even this involves minor risks of developing serious complications such as:
- Eye infections
- Possibility of eye opacity (cataract)
- Increased intraocular pressure (glaucoma)
- Problems with the sutures used during surgery
- Rejection of transplanted corneal
- Inflammation of the cornea


Signs and symptoms of corneal rejection

In some cases, the body’s immune system might mistakenly attacks the transplanted cornea. This is called rejection and may require treatment or other corneal transplant. Consult your doctor if you notice any of the following symptoms:
- Loss of vision
- Pain
- Redness
- Sensitivity to light.

Rejection occurs in approximately 20% of cases of corneal transplant. Every 10 people that support corneal transplant, two people may experience corneal transplant rejection.


Vision correction following the surgery

Vision may initially be weaker than before surgery because the eye must adjust to the new cornea. It may take several months before the vision to improve.

After the outer layer of the cornea is healed – weeks or months after surgery – the doctor may consider necessary to make some adjustments that could improve vision, such as:

- Correction of corneal shape irregularity (astigmatism) – stitches that keep the transplanted cornea position can cause inflammation and pits in the cornea and may cause that person to see blurry in some areas of the visual field. The doctor will correct some of these irregularities by weakening some stitches and tightening others.

- Correction of vision problems – such as refractive errors myopia and hyperopia can be corrected by wearing glasses, contact lenses or laser surgery.

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