Keratoplasty

Keratoplasty is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue. The cornea is the clear front part of the eye that transmits and focuses light into the eye. When the cornea becomes cloudy or distorted, a keratoplasty can restore or dramatically improve vision.

Types of Keratoplasty

There are several types of keratoplasty, including:

• Penetrating Keratoplasty (PK): This is the most common type of cornea transplant. It involves the surgical removal of the full-thickness central portion of the diseased cornea and replacement with a clear, full-thickness donor cornea.

• Deep Anterior Lamellar Keratoplasty (DALK): This procedure is similar to PK, but only the front and middle layers of the cornea are replaced. The back layer (endothelium) is left in place and the donor cornea is sutured onto it.

• Descemet's Stripping Endothelial Keratoplasty (DSEK): In this procedure, only the back layer of the cornea is replaced. The surgeon removes Descemet's membrane and the endothelium from the patient's cornea and replaces them with the donor tissue.

• Descemet's Membrane Endothelial Keratoplasty (DMEK): This is a newer procedure where only the Descemet's membrane and endothelium are replaced, without any stromal tissue.

Indications

Keratoplasty is indicated for conditions such as:

• Corneal edema
• Corneal dystrophy
• Keratoconus
• Corneal scarring
• Corneal ulceration

Procedure

The procedure is typically performed under local anesthesia. The surgeon uses a device called a trephine to cut the diseased cornea and remove it. The donor cornea is then placed in the opening and sutured into place. The procedure usually takes 1-2 hours.

Risks and Complications

As with any surgical procedure, keratoplasty carries some risks. These may include:

• Infection
• Glaucoma
• Cataract
• Retinal detachment
• Corneal graft rejection

Prognosis

The prognosis after keratoplasty is generally good. With proper care and follow-up, most patients can achieve good vision. However, the success of the procedure depends on the reason for the transplant, the patient's overall health, and the patient's ability to tolerate medication that suppresses the immune system.

Keratoplasty Resources
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