Corneal button

A human eye 1 day after a cornea transplant

Corneal button refers to a circular piece of cornea that is used in corneal transplantation or keratoplasty. This procedure is essential in treating various corneal diseases that can lead to vision impairment or loss. The corneal button is surgically excised from a donor's cornea and then transplanted into the recipient's eye, replacing the damaged or diseased corneal tissue.

Overview

The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. It plays a crucial role in focusing visual images onto the retina, making it vital for clear vision. Corneal diseases or damage can significantly affect the quality of vision, leading to the need for a corneal transplant.

Indications

Corneal buttons are used in various types of corneal transplants, including penetrating keratoplasty (PK), where the entire cornea is replaced, and lamellar keratoplasty, where only certain layers of the cornea are replaced. Indications for a corneal transplant include:

• Keratoconus - a progressive thinning and bulging of the cornea.
• Fuchs' dystrophy - a degenerative disease affecting the innermost layer of the cornea.
• Corneal scarring - resulting from infections (such as keratitis) or injuries.
• Corneal ulcers - open sores on the cornea.
• Endothelial dysfunction - failure of the innermost corneal layer, leading to corneal swelling and vision loss.

Procedure

The procedure for transplanting a corneal button involves several steps:

1. The recipient's diseased or damaged cornea is carefully measured to determine the size of the corneal button needed.
2. A similar-sized corneal button is then excised from a donor cornea using a specialized instrument called a trephine.
3. The recipient's damaged cornea is removed, and the donor corneal button is placed in the recipient's eye.
4. The corneal button is then sutured into place, and the eye is bandaged to protect it during the initial healing process.

Postoperative Care

After a corneal transplant, patients are required to take several precautions to ensure proper healing and to reduce the risk of complications. These include:

• Using prescribed eye drops to prevent infection and reduce inflammation.
• Wearing an eye patch or protective shield to safeguard the eye.
• Avoiding rubbing or pressing on the eye.
• Attending regular follow-up appointments to monitor the healing process.

Risks and Complications

As with any surgical procedure, corneal transplantation carries certain risks and complications, such as:

• Rejection of the donor cornea.
• Infection.
• Issues with the sutures, such as loosening or irritation.
• Glaucoma.
• Astigmatism or other vision changes.

Conclusion

Corneal buttons play a crucial role in corneal transplantation, offering hope for restored vision to individuals suffering from corneal diseases. Advances in surgical techniques and postoperative care have significantly improved the success rates of these transplants, making it a viable option for many patients with corneal pathology.