Cornea Transplantation
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What is Cornea Transplantation?
Understanding About
Cornea Transplantation
Corneal disease ranks as the fifth leading cause of blindness in the world. Keratoplasty is the most common and successful transplantation in humans with the first transplant completed in 1905.
The first successful human allograft and penetrating keratoplasty (PK) followed developments in anesthetics and antiseptic surgery and was performed by Eduard Zirm in December 1905 on a 45-year-old farm laborer with lime burns.
Scientific advances in immunology, surgical technique, and tissue banking have shaped corneal transplantation into the field it is today.The last 20 years have brought significant developments in selective endothelial replacement that have brought about considerable shifts in the field.
Symptoms
Treatments
Precautions
Symptoms
Corneal Transplantation symptoms include
- Pain
- Blurred Vision
- Sensitivity to Light
- Redness and Irritation
- Foreign Body Sensation
- Tearing
- Graft Rejection Symptoms
Treatments
Treatments for Cornea Transplantation
- Cornea transplantation involves two main procedures: penetrating keratoplasty (PK) and Descemet’s membrane endothelial keratoplasty (DMEK).
- PK replaces damaged cornea with a donor cornea by cutting and suturing circular buttons of host and donor tissue. Postoperative antibiotic therapy prevents infection, and shielding promotes healing.
- DMEK focuses on replacing the endothelial layer of the cornea. It involves removing the Descemet’s membrane and endothelium and replacing it with a donor corneal endothelial graft. Antibiotic therapy and shielding aid in postoperative recovery.
Precautions
Precautions for Cornea Transplantation
- Cornea transplantation involves precise surgical techniques and thorough postoperative care.
- In PK (Penetrating Keratoplasty), accurate corneal diameter measurement and precise trephination are essential to avoid size discrepancies. Careful suturing prevents complications like iris adhesion. Viscoelastic hyaluronic acid can be used to prevent iris adherence.
- For DMEK (Descemet’s Membrane Endothelial Keratoplasty), creating paracentesis sites and corneal incisions with precision minimizes tissue trauma. Delicate handling during Descemet’s membrane scoring and peeling prevents damage. Staining the donor button aids visibility, and injecting an air or gas bubble ensures proper adhesion. Postoperative antibiotic therapy and shielding are vital essential to prevent infection and promote healing. Strict adherence to surgical protocols, careful tissue handling, and vigilant postoperative care are crucial precautions for cornea transplantation to achieve optimal outcomes.o prevent infection and aid healing.
Types of Cornea Transplantation
Different Types of
Cornea Transplantation
Before Surgery
During the Surgery
After the Surgery
Before Surgery
How you prepare for Cornea Transplantation Surgery
- Informed Consent: The procedure must be thoroughly explained to the patient, allowing sufficient time for them to understand and weigh the risks and benefits. Informed consent is then obtained from the patient.
- Medical History and Examination: A comprehensive medical history, including current medications and allergies, is obtained from the patient. An ophthalmic examination is also conducted to assess the condition of the eye.
- Medication Management: Patients, especially older individuals with comorbid conditions, may be on medications like anti-diabetic or anti-thrombotic drugs. Advice should be given regarding the management of these medications before the surgery, following established guidelines or protocols.
During the Surgery
How you prepare for Cornea Transplantation Surgery
- Patient Education and Consent: Explain the procedure, gather medical history, and discuss medication management.
- Anesthesia and Eye Prep: Administer anesthesia and prepare the eye using a speculum and fixation ring.
- Measurement and Donor Prep: Measure corneal diameter, prepare donor tissue if needed.
- Surgical Technique: Perform surgery based on transplantation type, excising host cornea and securing donor tissue.
- Complication Prevention: Take measures to prevent issues like pupillary block or infection.
- Closure and Post-op Care: Close incision, apply antibiotics, and shield the eye for healing.
- During surgery, clear communication among the team, patient, and caregivers ensures optimal outcomes.
After the Surgery
How you prepare for Cornea Transplantation Surgery
- Clear Instructions: Provide detailed guidance on medication, activity limitations, and hygiene practices.
- Complication Awareness: Educate patients about potential risks like infection or graft rejection and encourage reporting of any unusual symptoms.
- Follow-up Appointments: Schedule regular visits with the ophthalmologist to monitor progress and address complications early.
- Team Collaboration: Ensure coordination among healthcare professionals, including ophthalmologists, nurses, and primary care providers.
- Patient Education: Communicate clearly with patients and caregivers, providing contact information for emergencies.
Cornea Transplantation FAQs
Cornea Transplantation
FAQS
How long will the surgery take?
You will be in the operating room for 1-2 hours, but the actual surgery will take less time.
Will my vision change?
Vision usually is blurred after surgery. It gradually improves as healing takes place. As the eye heals and the sutures are removed, the shape of the cornea changes. Therefore, your surgeon usually will wait between 3 and 12 months before prescribing a new lens for your glasses. If needed, a contact lens may be prescribed.
When can I return to work?
This depends on your work activities, your comfort, and your vision. Some patients with desk jobs can return to work within a few days. Other people can be off work for a few weeks.
When can I stop worrying about the chance of graft rejection?
The risk of corneal transplant rejection is low. However, it is possible to have a rejection at any time – even many years after your transplant surgery – and it is important to know the signs of rejection. A corneal transplant can be repeated, usually with good results. However, the overall rejection rates for repeated transplants are slightly higher than for the first transplant.
When can I drive?
If the vision in your other eye is adequate for driving, you may drive after the anesthetic has completely worn off. This may take up to 24 hours. Your surgeon may recommend you wait several days before driving. Remember, you must have someone to drive you home from the hospital as well as someone to bring you back the next day for your follow-up visit.
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