Keratoplasty: Overview


Keratoplasty : all what you need to know 

Keratoplasty is a common surgery which goal is to repair a damaged cornea. When performed by the right surgeons, the risks of a cornea transplant are low. 

Here is all the necessary information that you need to know about Keratoplasty ! 

What is keratoplasty ? 

Various pathologies such as keratoconus can lead to permanent vision loss. In such critical cases, it is necessary to perform a corneal transplantation. This type of surgery is commonly called keratoplasty. 

The procedure involves replacing a damaged cornea with a healthy one from a donor. Also known as penetrating keratoplasty, corneal transplantation has given many patients the chance to regain good vision after suffering from corneal opacity. 

Studies have shown a success rate of over 66% for this operation on a five-year follow-up of patients suffering a damaged cornea. Hence, keratoplasty is considered a safe treatment to cure several severe vision-related pathologies. 

Keratoplasty : all what you need to know

Why is corneal transplant performed ? 

Keratoplasty is performed to repair a damaged cornea due to several reasons : 

  • Pseudophakic bullous keratopathy : it occurs in 1 to 2% of cataract surgeries, because of cell loss and endothelial decompensation through trauma during the intervention. The most common symptoms of this disease are tearing eyes, and pain due to ruptured epithelial bullae.
  • Keratoconus : although it is more common among the elderly, keratoconus can occur for genetic reasons or after cataract surgery, causing a scarred cornea. The disabling symptoms include eye sensitivity to light, blurring vision, strong pain, the sensation of a foreign object in the eye and a decreased vision.
  • Infectious keratitis : it is a cornea inflammation that can be caused by a virus or a bacteria. Antibiotics, steroids, anticollagenes and topical treatments are the most common treatments for infectious keratitis. However, in case of a damaged cornea, keratoplasty is often performed.
  • Fuchs dystrophy or hereditary dystrophiesthis condition is characterized by the failure of the pump cells lining the back surface of the cornea, making it absorbs water. It generally causes pain and blurry vision.
  • Post-traumatic scar tissue trauma-related cornea scarring is a common issue occurring after an accident. It can be easily treated with keratoplasty.
The cornea transplant procedure

The cornea transplant procedure

Time of the surgical procedure lasts between 30 minutes to 1h30, depending on the surgical technique chosen by the surgeon (penetrating keratoplasty, endothelial keratoplasty, anterior lamellar keratoplasty, deep anterior lamellar keratoplasty). An overnight hospital stay is generally required. In some cases the patient must spend one more night under observation. 

The patient is seen by the surgeon in the first 24 hours following the operation, during a consultation at the clinic.

Antibiotics as well as an anti-inflammatory treatment (cortisone) are prescribed in the shape of eye drops for a period of 3 to 12 months, depending on the type of keratoplasty that has been performed.

It is up to the surgeon to choose the most suitable type of cornea transplant for each patient.

Infectious risks are rare, as long as the patient follows the surgeon’s instructions.

After a cornea transplant

The patient must respect the prescriptions of the doctor, otherwise the graft can be rejected and other serious complications may occur. 

The medical treatment can cause side effects such as glaucoma, cataracts, and even ophthalmic herpes. For this reason, the doctors carry out a rigorous and permanent follow-up after any kind of surgical intervention. 

On the other hand, the ophthalmologist must be informed urgently if any adverse effect appears such as pain, headaches or reduced visual acuity. This will allow the doctor to readjust the treatment as quickly as possible and to make sure that there is no cornea rejection. 

Instructions to follow after a keratoplasty

Following a cornea transplant, some instructions must be respected to protect the eyes :

  • wear sunglasses to avoid any injury to the operated eye
  • avoid touching the operated eye.

During the first month after the surgery, you will also have to :

  • avoid lifting heavy objects
  • avoid tilting your head forward for too long
  • avoid any violent physical exercise
  • do not rub your eyes and squeeze your eyelids.

What results should be expected after a keratoplasty ? 

The healing process may vary from one individual to another. In fact, the recovery of a functional vision depends on the type of keratoplasty, varying between 1 month up to 12 months or more after the surgery although some people can recover their vision in the early postoperative time. 

The first sutures should be removed by the surgeon from the cornea a few weeks after the procedure. However, after a few months, all sutures will need to be removed to help relieve astigmatism once the cornea begins to show signs of good healing.

Need for information?

Last update: 22/04/2024

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