Corneal transplantation: when to do it?

Corneal transplantation, also known as keratoplasty, is the replacement of corneal tissue when it is opacified and there is no way to recover transparency. Nowadays, this procedure has evolved and only the opacified part of the cornea can be replaced. There are three modalities, anterior keratoplasty, in which the two anterior layers are transplanted, endothelial keratoplasty, where only the inner layer is transplanted, and penetrating keratoplasty, where the entire thickness of the cornea is transplanted.

Why is corneal transplantation performed?

The causes for which a corneal transplant may be necessary due to a loss of transparency in the eye are a post-ulcer scar or trauma, corneal dystrophy or corneal degeneration, ectasia or deposition. Seeing through a corneal opacity is like looking through tinted glass, which does not allow seeing defined shapes.

During corneal transplantation, cataract surgery or ocular reconstruction of the eye may also be performed after perforating trauma that has de-structured the eye.

How is corneal transplantation performed?

Corneal transplant surgery is usually performed under local anesthesia and without hospitalization. The procedure consists of removing the central part of the opacified cornea and suturing a part of the healthy and transparent cornea from a donor using 16 stitches. The eye must be closed for 24 hours.

After the operation, the patient has to apply eye drops and take antibiotics and anti-inflammatory drugs as explained by the specialist. In addition to the risks of infection and inflammation, there is a risk of rejection, since it is an organ from another person. For this reason it is important that there is a very strict control and an active collaboration of the patient to detect, in an early way, if there is any problem.

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The recovery of vision is fast, although the visual result cannot be known with certainty until the sutures are removed. Normally, a year after the sutures are removed, an optical correction will be required, which can be corrected with glasses, contact lenses or laser refractive surgery.

The importance of donations

The donation of eyes is very important so that these types of surgeries can finally be performed and patients can recover their vision. Everyone can be a donor, regardless of age, diopter or blindness, as long as the cornea is in good condition. In Catalonia about 1,000 corneal transplants are performed every year, so many donations are needed.

For more information, please consult the website of the Institut CatalĂ  de la Retina.