The corneal transplant

Definition

Corneal transplant involves replacing diseased cornea with a healthy cornea from a deceased donor. Keratoplasty (medical name of the corneal transplant) is an eye surgery which allows many patients to regain good vision when they were holders of a corneal opacity or distortion of the cornea that made them, if not blind, at least visually.

Treatment

Many surgical techniques exist.

• It makes a complete change of the entire corneal thickness then it is a corneal transplant transfixing.
• You can also perform only one change in the affected part of the cornea. This is called a lamellar corneal transplantation. The latter type of intervention is currently developing a technique has become highly practiced routinely in the clinic. The corneal transplant is now reserved as transfixing some cases. Indeed, it is illogical to change a part of healthy cornea, it is better to change only the diseased parts of the cornea.

The procedure requires a short hospital stay (usually overnight) to be followed by close monitoring. The patient's activity is reduced during the first weeks because the healing must take place before considering a normal activity. There is an observation period of several months. The local care are reduced to the instillation of drops. Some sports will be banned permanently because of the high risk of trauma (boxing, rugby, for example). Gradually become less frequent controls and the patient will be reviewed once a year if all goes well. In the vast majority of the operated eye has little or no pain. The visual recovery is gradual.

Monitoring will be performed by the surgeon who performs all of our transplant center. If it is absent, the entire medical team will take care of you. Medical monitoring of patients is paramount in emergency surgery in the transplant, any delay in treatment can be detrimental. Should be consulted in an emergency if the eye becomes painful, if the eye becomes red or if you have low vision. These signs may be related to an early release, which in most cases is split if it is caught early. Remember that an eye is grafted to an eye always more fragile requiring regular monitoring.
Removal of the son of suture may be necessary, it is then carried out in consultation.

Résults

We reach more than 85% of success. But these results are a function of eye diseases that led to the transplant.

Complications

Serious complications of the operation are rare.
The rejection is the main complication of corneal transplant. The frequency ranges from 10% to 50% of discharges depending on the condition that necessitated the transplant and the type of graft (anterior lamellar grafts and posterior lamellar graft rejection are less than transfixing transplants). It appears from the first week after surgery and up to 20 years after it. It can be treated with medication with some effectiveness. In case of failure of this treatment the graft is opaque and vision is very low. A second transplant is possible but the risk of failure is increased.

As a further complication there:

• The infections affect 2 to 5 in 1000
• Increased eye pressure
• The trauma of the eye by the patient or his environment
• The deformation of the cornea graft (astigmatism) is common
• The central retinal edema.