Keratoplasty

Keratoplasty, also known as corneal transplant, is a surgical procedure to replace part of the cornea with corneal tissue from a donor.

Types of Keratoplasty

• Penetrating Keratoplasty (PK): This is the most common type of keratoplasty, where the entire thickness of the cornea is replaced with a donor graft.
• Lamellar Keratoplasty (LK): This type of surgery involves replacing only the diseased layer of the cornea, rather than the full thickness.
• Endothelial Keratoplasty (EK): This is a type of lamellar keratoplasty that specifically targets the innermost layer of the cornea, the endothelium.
• Descemet's Stripping Endothelial Keratoplasty (DSEK): A variation of EK, where the diseased endothelium is stripped away and replaced with a donor graft.
• Descemet's Membrane Endothelial Keratoplasty (DMEK): A more advanced version of DSEK, where only the Descemet's membrane and endothelium are replaced.

Indications for Keratoplasty

Keratoplasty is typically performed to treat corneal diseases or injuries that cause vision loss or blindness, including:

• Corneal ulcers or infections
• Fuchs' endothelial dystrophy
• Pseudophakic bullous keratopathy
• Keratoconus
• Corneal scars or trauma

Surgical Procedure

The surgical procedure for keratoplasty typically involves:

• Administration of local or general anesthesia
• Removal of the diseased corneal tissue
• Preparation of the donor graft
• Suturing or attachment of the donor graft to the recipient's eye

Postoperative Care and Recovery

After keratoplasty, patients typically require:

• Frequent follow-up appointments with their surgeon
• Use of topical medications to promote healing and prevent rejection
• Avoidance of strenuous activities or rubbing the eye
• Wearing an eye shield or patch to protect the eye

Risks and Complications

As with any surgical procedure, keratoplasty carries risks and potential complications, including:

• Graft rejection
• Infection
• Glaucoma
• Cataract formation
• Retinal detachment

Prognosis and Outcome

The success rate of keratoplasty varies depending on the type of procedure, the underlying condition being treated, and individual patient factors.

With proper postoperative care and follow-up, many patients can achieve significant improvement in their vision and quality of life.