Mary River Eye Specialists

Corneal transplant surgery

Understanding the Cornea

The cornea is the uppermost lens of the eye; it functions as a translucent window, regulating and focusing the light that penetrates the eye. The cornea has to be translucent and have a seamless, persistent curvature if one is to have the most pleasing vision.

How Does Corneal Transplantation Act?

Corneal transplantation, also comprehended as keratoplasty, implicates replacing a diseased or scarred cornea with a healthy one acquired from a deceased donor. This surgical approach is paramount for reforming clear vision when the cornea becomes unclear or distorted.
Corneal transplant surgery

Reasons for Undergoing a Corneal Transplant

Corneal transplants are naturally essential when conditions such as keratoconus, corneal ulcers, or intricacies from prior eye surgeries affect the cornea’s ability to remain clear and correctly shaped. These issues can seriously harm vision, making a transplant a viable option for healing.

Varieties of Corneal Transplants:

The method for corneal transplantation varies depending on the affected corneal layer:

  • Penetrating Keratoplasty: This full-thickness transplant is executed when all layers of the cornea are injured.
  • Endothelial Transplant (e.g., DMEK): This is instructed when the innermost layer of the cornea, the endothelium, is compromised.
  • Deep Anterior Lamellar Keratoplasty: This approach aims at the foremost layers of the cornea, mainly the stroma when they are impacted.

Each type of transplant addresses specific layers of the cornea, ensuring tailored treatments that best suit the patient’s needs.

This interpretation strives to provide a clear and comprehensive explanation of the cornea and corneal transplants, tailored for more acceptable readability and understanding.

Penetrating keratoplasty

A Penetrating Keratoplasty (PK) is a corneal transplant in which the full thickness of cornea is removed from the recipient and replaced with a new cornea from a donor.  This new transplant is  sutured (“stitched”) in place using very fine sutures so small they are very difficult to see with the naked eye.

Deep anterior lamellar keratoplasty

A Deep Anterior Lamellar Keratoplasty (DALK) is a corneal transplant in which the front 95% of your cornea is replaced with healthy cornea from a donor.  The transplant is.

The benefits of a DALK compared to a traditional full thickness corneal transplant (Penetrating Keratoplasty) are several

  • There is a significantly reduced risk of your immune system rejection your transplant
  • There is a lower risk of developing high pressure in the eye (glaucoma) in the weeks and months following surgery.
  • There is a lower risk of bleeding during the surgery

Descemet’s membrane endothelial keratoplasty (DMEK)

In some diseases, only the inside layer (endothelium) is affected, causing corneal oedema (swelling) and clouding.

DMEK is a modern type of corneal transplant operation in which the inside layer of your cornea (endothelium) is replaced with the inside layer from a donor cornea through a small incision (opening). 

The endothelium from the donor (transplant or graft) is inserted and pressed in position against the back of your cornea by a bubble of gas.

You can see a DMEK corneal transplant being performed here.