Diseased corneas can now be replaced successfully by transplanting a human donor cornea to the diseased eye. Replacing the unhealthy cornea with a healthy cornea is the only way of restoring vision. CORNEAL TRANSPLANTATION in is one of the most successful organ transplant surgeries.
Corneas for transplant come from individuals who have donated their eyes for use after death who is free from transmissible diseases like HIV, Hepatitis and Syphilis. The donor cornea is itself screened for any pathology and then stored in a nutritive medium temporarily till use.
The donor cornea is secured on the patient’s eye with fine thin sutures made of nylon; about 8 to 16 sutures are put. These sutures can be removed later on after a period of 3 to 6 months. The corneal transplant procedure can be combined with cataract surgery and lens implantation when it is called “triple procedure”.
The success rate of a corneal transplantation procedure is over 90% in majority of cases. However the patient needs to come for regular follow-up after surgery for early management of complications if they arise. The most common cause of failure of corneal transplant procedure results from graft rejection which can be successfully managed if recognized early.
ICL-Implantable Collamer Lens
As the name suggests, this is a Lens that is implanted into the eye positioned over the natural crystalline lens and behind the iris. This Lens can be used to treat those patients for whom LASIK is not possible. E.g. very high refractive errors, or thin corneas, stabilized Keratoconus.
It is a permanent lens and stays in the eye, thus obviating the need for daily use and removal as in contact lens users.
The implantation of this lens requires a detailed evaluation. Ask our Doctors for more details on the same.
Lamellar Corneal Transplants
The cornea is a transparent dome shaped structure covering the front of the eye. It consists of 5 layers, and a recently added 6th layer called Dua’s layer.
The cornea is peculiar in that it does not have any blood supply and hence is the only structure of the eye that can be transplanted.
Traditionally, corneal transplants involved removing the full thickness of the affected person’s cornea, and replacing it with a healthy donor cornea.
With advances in techniques of surgery, now a single cornea can be divided into atleast 2 parts – the front and back being used for different indications. This is called Lamellar Corneal Surgery. The biggest advantage of lamellar surgeries are that since only a part of the donor cornea is implanted, the chances of rejection are much lesser.
DSEK or Descemet’s Stripping Endothelial Keratoplasty involves replacing the affected endothelium of the patient with a healthy one from a donor cornea. The endothelium is the innermost layer of the cornea.
DALK or Deep Anterior Lamellar Keratoplasty involves removing the outer or front layers of the damaged cornea and replacing them with corresponding healthy layers from donor.
Depending on the extent of damage to the patients cornea and the level upto which the layers have been affected, any of the above procedure maybe advised.