Cornea Transplant Procedure

In cornea transplant surgery (keratoplasty), part of the patient’s cornea is replaced with cornea tissue from a donor. The cornea is the dome-shaped, transparent surface of the eye. The light enters the eye through the cornea. The cornea plays an important role in having a clear vision. Cornea transplant surgery restores the vision of people with the damaged cornea. It can also improve symptoms or reduce pain caused by cornea-related diseases. Many corneal diseases can be treated via cornea transplant surgery. In this article from The Moj Aramesh Amitis Health Tourism Company, we will discuss diseases and problems caused by corneal injury.

 

Cornea Transplant Surgery & Treating Eye Diseases

Many eye conditions can be treated via cornea transplant surgery, including:

• A cornea that bulges outward (keratoconus)

• Fuchs’ dystrophy (a hereditary condition)

• Torn or thinned cornea
• Cornea injury (caused by infection or damage)
• Swelling of the cornea
• Corneal ulcers not responding to medical treatment

• Complications caused by previous eye surgeries

Cornea Transplant Surgery Pre-Operation Instructions

Before cornea transplant surgery, some instructions and recommendations must be considered. Visit an ophthalmologist to examine your eye health and general condition before the surgery.

Afterward, you can decide whether you are an ideal candidate for corneal transplant surgery or not. Some of these instructions and recommendations include:

•       A Complete Eye Examination Performed by an Ophthalmologist: an ophthalmologist will examine symptoms and type of your eye disease and your overall health status, to predict possible complications that may occur after the surgery.
•       Measurement of Your Eye: The ophthalmologist determines the size of the donor’s cornea (the cornea transplanted to your eye) to increase the success rate of corneal transplant surgery.
•       Reviewing all medications & supplements you take: You may need to stop taking specific medications or supplements before or even after your cornea transplant.

• Treating other eye diseases: Unrelated eye problems (such as infection or inflammation), may decrease the success rate of cornea transplant surgery. Therefore, your ophthalmologist will treat these problems before the surgery for better results.

Finding donor’s cornea:

Corneas used for transplant surgery, are from deceased people who died from various causes. The cornea of donors who died for unknown causes or donors with certain conditions (such as spreadable diseases) is not used for transplantation.

Unlike kidney or liver transplantation, in cornea transplant surgery tissue matching is not necessary. Donated corneas are widely available in countries such as the United States, so there’s usually not a long waiting list.

Procedures to transplant a portion of the cornea

During cornea transplant surgery, all or part of the diseased cornea is removed and replaced with healthy donor tissue. There are various methods of a cornea transplant. Your surgeon will decide which method to use. Keep reading on The Moj Aramesh Amitis Health Tourism Company’s Website to learn more about these methods.

These types of procedures include:

•       Penetrating Keratoplasty (PK):

PK is a full-thickness­­ cornea transplant. Your surgeon cuts through the entire thickness of the abnormal or diseased cornea to remove a small button-sized disk of corneal tissue. A special instrument is used to make this precise circular cut. A precise circular cut is made around the cornea, using a special device. The donor’s cornea (cut to fit), is placed in the opening site. The eye surgeon uses sutures to stitch the new cornea into place. The stitches used for cornea transplant might be removed at a later clinical visit with your ophthalmologist.

•       Endothelial Keratoplasty (EK):

In this method, diseased cornea tissue is removed from the back corneal layers, including the endothelium and a thin layer of tissue, protecting endothelium from damage or infection (Decement membrane), and the donor tissue replaced the removed tissue.

Types of Endothelial Keratoplasty

There are two types of endothelial keratoplasty:

1. Descement Stripping Endothelial Keratoplasty (DSEK):

in this procedure, the donor corneal tissue replaces about one-third of the diseased cornea.

2. Descement’s Membrane Endothelial Keratoplasty (DMEK):

in this procedure, a much thinner layer of donor cornea tissue is used. The tissue used in this method is extremely fragile and thin, therefore, this method is more challenging than DSEK, and is also more commonly used.

•       Anterior Lamellar Keratoplasty (ALK):

In ALK, front corneal layers, including epithelium and stroma are removed, but leave the back endothelial layer in place.

•       Artificial Cornea Transplant (keratoprosthesis): 

In some cases, if the patient is not eligible for a cornea transplant, using a donor cornea, the ophthalmologist may use artificial cornea transplant surgery (keratoprosthesis). In this part, all methods of cornea transplant surgery were fully explained. Based on your condition, your surgeon will decide which method is suitable for you and informs you about the details, results, and possible complications of each method.

What happens during cornea transplant surgery?

On the day of your surgery, you will either be given sedatives and a local anesthetic to numb your eye, or you’ll be put to sleep, not to feel any pain. Cornea transplant surgery will be performed on one eye at a time. In some cases, only an eye may be injured. Depending on the amount of damage, used surgical method, and the number of corneas transplanted, the amount of time spent in surgery will be different for each patient.

Cornea Transplant Surgery Post-Operation Instructions

Your medical team or the surgeon will give you all the necessary instructions after the surgery. Follow them precisely for the best results./ Possible Risks of cornea transplant

Keep reading on The Moj Aramesh Amitis Health Tourism Company’s website to learn more about cornea transplant post-op recommendations and instructions, including:

•       Use prescribed medications on time and properly:

Using eye drops and medications immediately after the cornea transplant surgery and during recovery will help control pain, infection, and swelling. Eyedrops prevent cornea rejections by suppressing the immune system.

•       Wear eye protection:

Wearing eye protection or different glasses after the surgery and during recovery protects your eyes.

•       Lie on your back:
• Depending on the type of transplant and used method, you may have to lie on your back for a while after the surgery as it accelerates your healing process. This will put less pressure on your eyes.

•       Avoid dangerous activities:

Avoid strenuous activities that may harm your eye such as martial arts. You can resume your daily activities after a while after the surgery. Avoid putting pressure on your eyes after the surgery. It is necessary to take extra precautions to avoid harming your eyes and get better results after the surgery.

Visit your ophthalmologist frequently: Expect to see your eye doctor regularly in the year after surgery to monitor your progress and look for complications.

Possible Complications of Cornea Transplant Surgery

Before using any organ to perform transplantation surgeries, the medical history of the donor is reviewed. Assessing the donor’s physical condition and health can help identify various diseases (such as rabies) in the donor’s body and prevent them from being transmitted to the recipient of the cornea. For example, blood samples are taken from all donors of various organs, including the cornea. This will prevent transplanting diseased organs to the recipient (such as hepatitis B, hepatitis C, and HIV). The donor’s cornea is stored in the eye bank before being sent to the hospital where the corneal transplant surgery is scheduled to be performed. The donor’s cornea is carefully examined to reduce the risk of transmitting various infections, bacteria, and fungi to the recipient’s body. Therefore, the chance of transmitting infection through transplantation is highly reduced. Anyway, you cannot donate blood or organ after the cornea transplant surgery as diseases may be transmitted through the surgery. To maintain your vision (which you gained as a result of cornea transplant surgery), you need to follow a series of necessary tips and care regarding the period after cornea transplant surgery. Here are some tips and tricks:

Traveling to Iran for Cornea Transplant Surgery

Corneal transplant surgery has been performed in Iran since a long time ago. Iran is one of the leading countries in the field of performing various surgeries, including corneal transplant surgery. Iran has been able to make significant progress in performing corneal transplant surgery in recent years. The Eye Bank of Iran exports the corneal tissue of donors to other countries. In addition, the cost of corneal transplant surgery in Iran is much lower than in other countries. Therefore, by choosing Iran as the final destination for your corneal surgery, in addition to economic savings, your corneal transplant surgery will be performed correctly./ Cornea Transplant in Iran

In this article, from The Moj Aramesh Amitis Health Tourism Company, the stages of corneal transplant surgery were discussed. You will go through different stages in cornea transplant surgery. You can choose the best method for your corneal transplant surgery and find out if you are a good candidate for corneal transplant surgery by visiting an ophthalmologist.

Author: Sh. Khazaei

Translator: N. Rahimifar