Corneal transplants replace all or part of a damaged cornea with healthy tissue from a donor. There are different types of corneal transplants, depending on the areas of the cornea that need to be replaced. A corneal transplant is often referred to as keratoplasty or a corneal graft. This procedure can be used to improve vision, relieve pain and treat severe infections.
Conditions affecting the shape of the cornea include Keratoconus. The cornea instead of being round is shaped like cone and has considerable astigmatism. Fortunately the majority of patients with Keratoconus are able to see with glasses or contact lenses, however in their lifetime 15% are likely to become intolerant to lenses and may require surgery, either Intacs if suitable or a corneal transplant.
A corneal transplant is a sophisticated operation and best in the hands of an experienced corneal surgeon. At Centre for Sight you have the peace of mind of being treated at an internationally renowned centre with patients referred from all over the world. Our expertise is not just from our years of experience but also from innovation and development of new techniques for corneal grafting as illustrated for example in the prize winning video on the Femtosecond Laser Deep Anterior Lamellar Keratoplasty page.
This technique removes a thin layer of the front of the cornea that might be irregular or scarred. A thin graft is created with the same device and stitched onto the surface. The technique has the advantage of rapid visual recovery. It is very useful in those with Reiss-Buckler’s corneal dystrophy and scarring from photorefractive keratectomy.
The Intralase femtosecond laser provides surgeons with the ability to make very precise incisions in the cornea and these can be combined in a multitude of ways to enhance penetrating keratoplasty or full thickness graft surgery.
This minimally invasive procedure has revolutionised corneal grafting for conditions such as:
Fuchs Endothelial Dystrophy
Pseudophakic Bullous Keratopathy
Unlike a traditional full thickness graft where a cornea is completely removed and a new one stitched in, the DSEK/DSAEK procedure involves only replacing the innermost layer of the cornea through a small (4mm) incision.
Full thickness grafts are being performed less and less often.
Safer and less invasive techniques such as DALK (Deep anterior lamellar keratoplasty) and DSAEK (Descemet’s stripping Automated Endothelial Keratoplasty) have replaced traditional penetrating keratoplasty. However there are situations where a PK is the only option for instance where all layers of the cornea are involved as in corneal trauma or a re-graft where a previous graft has failed.
Lasers are more precise. The same lasers used for laser eye surgery have been adapted for use in corneal transplants and Centre for Sight has been an innovator in this area.
Authored by Sheraz Daya MD FACP FACS FRCS(Ed) FRCOphth
Mr Daya is the Medical Director of Centre for Sight and listed amongst the 100 most influential ophthalmologists in the world (https://theophthalmologist.com/power-list/2018/sheraz-daya/).
Next review due June 2025.
