Do you sometimes feel like the world is blurry? Do you feel like your vision is gradually decreasing along with pain and itching in your eyes? It is normal to feel very scared when you experience something like this. Most of the time, the cause of this can be some damage to your cornea. But don't worry, with advanced medical science today, there are very effective solutions for this. Today, we will talk about one such solution, which is corneal transplant surgery.
Simply put, what is a cornea transplant?
A corneal transplant is a surgical procedure that removes the damaged cornea of your eye and replaces it with a healthy cornea. This is also called `Corneal grafting` or `Keratoplasty`.
Think of it like a camera. The cornea is the lens of the camera. It is the transparent membrane at the front of the eye. In order for us to see the world clearly, light must pass through the cornea. If the cornea is damaged in any way, such as a scratch, infection, or other medical condition, our vision will become blurry.
A corneal transplant involves removing this damaged "lens" and replacing it with a completely healthy cornea donated by a deceased person. This is a life-changing surgery that has restored vision for many people.
In what cases is a corneal transplant necessary?
There are several situations in which your eye doctor may recommend this surgery. The main ones are:
- Fuchs' dystrophy: This is a genetic disease. In this disease, the cells in the inner layer of the cornea are gradually destroyed, causing the cornea to swell and blur vision.
- Keratoconus: This is a condition in which the cornea changes shape and bulges forward into a cone-shaped shape. This causes vision to become distorted.
- Corneal ulcers: An infection, especially a bacterial or viral infection, can cause ulcers on the cornea and leave scars.
- Accidents: Getting hit in the eye, getting stabbed with a sharp object, or getting a chemical spill can cause serious damage to the cornea.
- Damage caused by previous eye surgeries: Sometimes, the cornea can be damaged as a side effect of other eye surgeries.
- Bullous keratopathy: A condition in which blister-like swellings form on the cornea.
In this situation, if you experience symptoms such as blurred vision, eye pain, and inability to look at light, it is very important to see your doctor immediately for advice.
What are the main types of corneal transplants?
Depending on the layer of the cornea that is damaged, your doctor will determine the type of surgery that is right for you. There are three main types of surgery.
| Type of surgery | Simply explained |
|---|---|
| Total Corneal Transplantation (Penetrating Keratoplasty) | This is the traditional method. Here, the entire thickness of the damaged cornea, that is, the outer, middle, and inner layers, is cut out in a circular shape and removed, and a healthy cornea of the same size is transplanted and sutured. |
| Deep Anterior Lamellar Keratoplasty (DALK) | If the damage to your cornea is only in the outer and middle layers, and the innermost layer (endothelium) is healthy, this surgery is performed. This involves removing only the two damaged layers and replacing them with healthy tissue. |
| Endothelial Keratoplasty (DMEK/DSAEK) | If the damage is only to the innermost layer of the cornea (e.g. Fuchs' dystrophy), this method is used. Here, only the damaged inner layer is removed and a very thin healthy layer is transplanted in its place. There are very few stitches. An air bubble is inserted into the eye to hold the transplanted membrane in place. |
Something special about Endothelial Keratoplasty surgery
If you have a surgery like `DMEK` or `DSAEK`, you will be given special instructions for the first few days. That is, to lie face up while sleeping and resting. When you do this, the air bubble that was inserted into the eye helps to keep the newly transplanted cornea in place and hold it in place. This is very important for the success of the surgery.
Things we need to be aware of before and after surgery
Preparation before surgery
Your doctor and anesthesiologist will review your health history and answer any questions you may have about the surgery.
- Tell your doctor about any medications you are taking. Some medications may require you to stop taking them before surgery.
- They will advise you on when to stop eating and drinking before surgery.
- Since you will not be able to drive after surgery, arrange in advance for someone to take you home.
Things to take care of after surgery
The surgery usually takes less than two hours, after which you can go home.
- Eye protection: The eye may be red, slightly sore, and sensitive for the first few days. Use the eye patch as directed by your doctor. Never rub or press on your eye.
- Medications: Eye drops are given to prevent infection, reduce swelling, and prevent the body from rejecting the transplanted cornea. These medications may need to be used for a year or more.
- Activities: You may need to temporarily stop activities that could put your eyes at risk, such as heavy lifting and running or jumping. Your doctor will advise you on this.
- Medical Checkups: The doctor will schedule a follow-up appointment within 24-48 hours of the surgery. Be sure to attend the clinics on the scheduled dates.
What are the benefits and possible complications of this surgery?
The main benefit is that you can see the world clearly again, which was previously blurry. The joy that comes with it is priceless. This is usually a very safe surgery.
However, as with any surgery, complications can occur.
The main risk is organ/cornea rejection. This means that our body's immune system recognizes the new cornea as 'foreign' and fights against it. The goal of continuing to use eye drops is to reduce this risk.
Other complications:
- Eye infections.
- Bleeding.
- Increased eye pressure (Glaucoma).
- Detached retina.
- Astigmatism occurs due to the irregular shape of the transplanted cornea.
If you have these symptoms, see a doctor immediately!
It is very important to take good care of your eye after surgery. If you experience any of the following signs of rejection , call your doctor immediately.
- Eye pain (Pain)
- Redness of the eye
- Light sensitivity
- Blurry Vision
If these symptoms are identified and treated early, rejection can often be controlled.
How long does it take to heal?
This will vary depending on the type of surgery you had.
- If a complete corneal transplant (Penetrating Keratoplasty) is performed, it can take about 12 months to regain full vision.
- If you have undergone Endothelial Keratoplasty (DMEK/DSAEK) surgery, you can achieve good vision in as little as 3 months.
Take-Home Message
- Corneal transplantation is a surgery that replaces a damaged cornea with a healthy one, and it produces very successful results.
- Depending on your condition, your doctor will determine the type of surgery (full, partial, or inner layer only) that is right for you.
- Follow your doctor's instructions carefully after surgery, especially regarding the use of eye drops and eye protection.
- Watch for signs of rejection, such as pain, redness, sensitivity to light, or blurred vision. If this occurs, seek medical advice immediately.
- It takes time to fully recover, so stay patient and positive. Stay in touch with your doctor regularly and discuss your concerns.
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