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A Cornea Implant is a surgical procedure of replacing all or the parts of cloudy or oddly formed cornea if both the front and outer layer seems to be severely damaged and implant a healthy cornea received from a healthy donor’s eyes. The process of replacing entire cornea simply known as Penetrating Keratoplasty (PK) a.k.a. full thickness cornea transplant and the process of removing a portion of damaged corneal tissue is known as Lamellar Keratoplasty. So, keratoplasty, in medical term, simply refers to the transplantation of cornea. A Healthy cornea can only be acquired through an eye bank that harvest, prepares and stores donor cornea for implantation.
The corneal implant becomes the last resort of patients to improve their vision, when every other medication seems to be proven less effective or ineffective to restore the normal vision. However, if the cornea is damaged and irreparable due to trauma or disease, then the transplant is done to maintain the structural integrity of the eye.
Your damaged and irreparable cornea is removed and then the clear donor cornea is sewn in its place.
What is Cornea?
The Cornea is a transparent layer forming the front of the eye. This outermost layer has a primary objective to focus and transmit light, making things visible to naked eyes. It seems a very thin substance, is actually a highly organized isolated group of cells and proteins with no connection to blood vessels to protect or nourish it against infection. It must remain transparent to reflect light properly and must be free of any cloudy or opaque area. It works on the basic science of reflection and refraction of light. Objects can only become visible once cornea reflects the light and the interference between cornea and light will directly result in the blurred vision, even darkness will fall in front of you. So, any injury, disease or hereditary conditions can distort the cornea, making it swollen or cloudy and block the path of light and interfere with vision. Farsighted and shortsighted issues are associated with the quality of the cornea.
When a corneal transplant is necessary?
Corneal transplant becomes necessary under certain conditions:
- Corneal Clouding
- Corneal Infection
- Corneal dystrophy
- Corneal Injury
Types of Corneal Transplant
- Penetrating Keratoplasty (PK): this traditional implant procedure is followed when the full-thickness corneal transplant is required to restore the vision.
- Endothelial Keratoplasty (DSAEK, DMEK): this processs is performed when the extremely thin innermost black layer of the cornea is damaged and requires a partial transplant of Endothelium.
- Anterior Lamellar Keratoplasty (ALK, DALK): alternative treatment that selectively replaces the front part of the cornea when it is scarred or distorted, such as Keratoconus or certain dystrophies.
The eye surgeons begin the process with general anesthesia about an hour ago before disconnecting the cornea from the eye. An eyelid speculum is placed to keep the eyelid open and some lubrication is placed in the eye to keep it moist and hydrated. An optical lens on the top of the eye is delicately picked by surgical instruments and removes the affected part of the cornea or whole cornea in a single move through a small incision and later, following the same delicacy, the healthy and fragile donor cornea is placed on its place. Fine nylon stitches are used to stitch the graft into its rightful place. In an endothelial transplant, a portion of the cornea is transplanted and much of the parts are left untouched, and air bubbles are used to attach the graft back to its place. This reduces the risk of rejection of donor cornea after surgery.
After the surgery, the eye is covered with an oval-shaped plastic pad that is attached in front of the eye with bandages to protect the newly implanted donor cornea from microorganisms and infection. Several eye drops will be prescribed for several years to ensure the adaptation of the cornea and reduce the chances of rejection. Your vision quality will be regularly examined after opening the bandages for any irregularities or pain or blurred vision and your ophthalmologist will explain you the recovery period.
Risks of surgery
With the modern technologies, risk factors have reduced to the minimum yet some minor risks still haunt with the failure of the process, occasional complications, rejection of cornea, chances of infection while the wound is healing, etc.
The patient will regain its full visibility. The process may cause some disturbing sensitivity but in the end, after the removal of the pad and bandages, you will feel a sense of satisfaction in being able to clearly observe the surroundings both farsighted and nearsighted.