Corneal grafting

Corneal Grafting

Corneal grafting, also known as corneal transplantation, keratoplasty, or corneal transplant, is a surgical procedure where a damaged or diseased cornea is replaced with a donated corneal tissue (the graft). This procedure is often recommended for individuals who suffer from vision loss due to corneal degeneration, corneal ulcers, or distortions in corneal shape like keratoconus. Corneal grafting can restore vision, reduce pain, and improve the appearance of a damaged or diseased cornea.

Types of Corneal Grafting

There are several types of corneal grafting, each tailored to address specific corneal conditions:

• Penetrating Keratoplasty (PK): This involves the transplantation of the entire cornea and is traditionally the most common type of corneal transplant.
• Lamellar Keratoplasty: Only layers of the cornea are replaced, which can be further categorized into:
  • Anterior Lamellar Keratoplasty (ALK): Replaces the front layers of the cornea, preserving the back layers.
  • Endothelial Keratoplasty (EK): Specifically targets the innermost layer of the cornea. This category includes Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) and Descemet's Membrane Endothelial Keratoplasty (DMEK).

Indications for Corneal Grafting

Corneal grafting is indicated for conditions such as:

• Keratoconus: A progressive thinning and bulging of the cornea.
• Corneal scarring: Resulting from infections (like keratitis) or injuries.
• Corneal dystrophies: A group of genetic corneal diseases, such as Fuchs' dystrophy.
• Corneal edema: Swelling of the cornea due to endothelial dysfunction.

Procedure

The corneal grafting procedure typically involves the following steps:

1. The recipient's damaged corneal tissue is removed.
2. A donor cornea, matched for size and tissue type, is sutured into place.
3. Post-operative care includes medications to prevent infection and rejection of the donor tissue.

Risks and Complications

As with any surgical procedure, corneal grafting carries risks, including:

• Graft rejection: The immune system attacks the transplanted tissue.
• Infection.
• Issues with sutures, such as irritation or infection.
• Glaucoma: Increased pressure in the eye.

Post-operative Care

Post-operative care is crucial for the success of a corneal graft. Patients may need to:

• Use eye drops to prevent infection and rejection.
• Attend regular follow-up appointments to monitor the healing process.
• Wear eye protection to avoid injuries during the recovery period.

Outcomes

The success of corneal grafting varies depending on the underlying condition being treated, but it generally has a high success rate. Vision restoration does not occur immediately; it can take several months for the eye to heal and for vision to stabilize.