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Modern era corneal transplantation


Jun 16, 2020

A corneal transplant removes either the entire thickness or the partial thickness of the diseased cornea and replaces it with healthy donor tissue. Your cornea surgeon will decide which method to use. These types of operations include:

  • Penetrating keratoplasty. This operation involves a full-thickness cornea transplant. Your surgeon cuts through the entire thickness of the irregular or diseased cornea to remove a small button-sized disk of corneal tissue. A special instrument is used to make this precise circular cut.The donor cornea, cut to fit, is placed in the opening. Your surgeon then uses stitches, also called sutures, to keep the new cornea in place. The stitches might be removed at a later visit with your eye doctor.
  • Endothelial keratoplasty. These operations remove diseased tissue from the back corneal layers. The layers include the endothelium and a layer of tissue called the Descemet membrane, which is attached to the endothelium. Donor tissue replaces the removed tissue.We offer the most recent most advanced type of endothelial keratoplasty, called Descemet membrane endothelial keratoplasty (DMEK), which uses a much thinner layer of donor tissue. The tissue used in DMEK is extremely thin so visual recovery is much quicker and visual outcomes are more superior than the older version DSEK.
  • Anterior lamellar keratoplasty (ALK). Two different methods remove diseased tissue from the front corneal layers, including the epithelium and the stroma. However, they leave the back endothelial layer in place.The depth of cornea damage determines the type of ALK operation that’s right for you. Superficial anterior lamellar keratoplasty (SALK) replaces only the front layers of the cornea. This leaves the healthy stroma and endothelium intact.A deep anterior lamellar keratoplasty (DALK) operation is used when cornea damage extends deeper into the stroma. Healthy tissue from a donor is then attached to replace the removed portion of the cornea. This process is known as grafting.
  • Artificial cornea transplant. If you aren’t eligible for a cornea transplant with a donor cornea, you might receive an artificial cornea. This operation is known as keratoprosthesis.

We will discuss which method of cornea transplant surgery is best for you, tell you what to expect during the operation and explain the risks of the operation.



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