Corneal transplantation
Corneal transplantation
Corneal transplantation is a surgical procedure in which diseased or damaged cornea is replaced by healthy, donated corneal tissue. Nowadays this is the most common transplant procedure. In America and Europe more than 40 000 operations are performed per year, and the efficinecy is over 90%.
Indications for corneal transplantation are:
• Optical – when operation is performed to improve vision
• Tectonic – correction of damaged corneal structure (stromal thinning, perforation)
• Terapeutic – tissue replacement due to refractory illness
• Cosmetic –improvement of the eye appearance without vision function expectations
Basically, every corneal opacity that can"t be treated in conservative way, under the assumption of healthy posterior eye segment, represents indication for corneal transplantation. The most common indications are: keratoconus, pseudophakic and aphakic bullous keratopathy, Fuchs distrophy, leucoma of the cornea, herpetic keratitis and previous transplant rejection. Less frequently transplantation is performed due to dystrophy and degeneration, traumatic scars or congenital opacity.
If you are a candidate for corneal transplantation, the procedure is as follows: it is necessary to do a complete ophthalmological examination that includes a slit-lamp examination, vision sharpness determination, eye pressure measuring, posterior eye segment examination, eye ultrasound, measuring for possible lens replacement etc. All required preoperative ophthalmological examinations can be performed in our Eyeclinic, while all examinations required for general anesthesia should be submitted on the day of operation. The operation is performed under general anesthesia, but in cases when patient"s condition requires, it can be performed under local anesthesia as well. Depending on corneal disease and whether the complete cornea is affected by pathological process or only corneal surface, it is possible to adjust surgical technique and apply the penetrating keratoplasty (full corneal transplantation) or lamelar keratoplasty (partial corneal transplantation depending on which part is the opacity).
In our Eyeclinic operations are performed by prof. Iva Dekaris and prof. Nikica Gabrić, experienced surgeons with several hundereds of surgeries in their hands. Professor Gabrić has founded the first Croatian Eyebank (LHOB) in 1995 and in 2002 he was the head of Referential Centre of the Ministry of Health and Welfare of the Republic of Croatia for corneal gathering, storage, distribution and transplantation. Professor Dekaris was the medical director of the first Croatian Eyebank, and from 2010 fills a post of the President of European Eye Bank Association (EEBA). We have to point out our excellent cooperation with foreign Eyebanks: International Sight Restoration in America and Vseobecná fakultní nemocnice in Prague that deliver us donor corneas, ordered individually for every patient, making sure that we"re getting the best corneas momentarily on the offer with the highest number of endothelial cells, which is the most important criteria for successful outcome of the operation. Age disparity between recipient and donor is aimed to be lower than 20 years.
The successful outcome of the operation depends on many factors where the most important one is the preoperative condition of the recipient"s eye, that is preoperative diagnosis, possible presence and rate of neovascularization and eye inflammation. Surgeon"s experience and skills are of great importance, while after the operation crucial is patient"s cooperation, application of prescribed therapy and early complications recognition. Excellent success rate (>95%) after transplantation have following diseases: keratoconus, inactive leucoma, Fuchs distrophy; very good success rate (80-90%) have pseudophakic bullous keratopathy, interstitial keratitis, macular distrophy; good success rate (50-60%) have herpetic, bacterial or funguos keratitis, keratitis sicca, endothelial distrophy; while low success rate (0-20%) have high-risk cases: previous transplant rejection, chemical trauma, radiation burn, Steven-Johnson"s syndrome.
The most important thing in postoperative process is patience. Corneal transplantation isn"t simple and recovery lasts for months. It is perfectly normal to have blurry sight and for vision to oscillate in the first couple of months, followed by stabilization. But it is to expect that spectacles or contact lenses will be necessary to correct astigmatism developed in the course of cornea stitching. After the operation patient has to make checkups every day for one week, then one time weekly, then 2 times per month, and afterwards one time monthly depending on the previous arrengement with the surgeon. The therapy is also determined individually and in majority of uncomplicated cases, only local drops are required (corticosteroids+antibiotic+artificial tears) several times per day, whereas in complicated cases the system treatment is also prescribed (steroids +/- cyclosporin).
It is our hope that we"ve brought you closer this type of operation. If you have any questions, please feel free to contact us either by phone or by e-mail.
Corneal transplantation is a surgical procedure in which diseased or damaged cornea is replaced by healthy, donated corneal tissue. Nowadays this is the most common transplant procedure. In America and Europe more than 40 000 operations are performed per year, and the efficinecy is over 90%.
>> Low-risk case: avascular leucoma
Indications for corneal transplantation are:
• Optical – when operation is performed to improve vision
• Tectonic – correction of damaged corneal structure (stromal thinning, perforation)
• Terapeutic – tissue replacement due to refractory illness
• Cosmetic –improvement of the eye appearance without vision function expectations
Basically, every corneal opacity that can"t be treated in conservative way, under the assumption of healthy posterior eye segment, represents indication for corneal transplantation. The most common indications are: keratoconus, pseudophakic and aphakic bullous keratopathy, Fuchs distrophy, leucoma of the cornea, herpetic keratitis and previous transplant rejection. Less frequently transplantation is performed due to dystrophy and degeneration, traumatic scars or congenital opacity.
>> High-risk case
If you are a candidate for corneal transplantation, the procedure is as follows: it is necessary to do a complete ophthalmological examination that includes a slit-lamp examination, vision sharpness determination, eye pressure measuring, posterior eye segment examination, eye ultrasound, measuring for possible lens replacement etc. All required preoperative ophthalmological examinations can be performed in our Eyeclinic, while all examinations required for general anesthesia should be submitted on the day of operation. The operation is performed under general anesthesia, but in cases when patient"s condition requires, it can be performed under local anesthesia as well. Depending on corneal disease and whether the complete cornea is affected by pathological process or only corneal surface, it is possible to adjust surgical technique and apply the penetrating keratoplasty (full corneal transplantation) or lamelar keratoplasty (partial corneal transplantation depending on which part is the opacity).
In our Eyeclinic operations are performed by prof. Iva Dekaris and prof. Nikica Gabrić, experienced surgeons with several hundereds of surgeries in their hands. Professor Gabrić has founded the first Croatian Eyebank (LHOB) in 1995 and in 2002 he was the head of Referential Centre of the Ministry of Health and Welfare of the Republic of Croatia for corneal gathering, storage, distribution and transplantation. Professor Dekaris was the medical director of the first Croatian Eyebank, and from 2010 fills a post of the President of European Eye Bank Association (EEBA). We have to point out our excellent cooperation with foreign Eyebanks: International Sight Restoration in America and Vseobecná fakultní nemocnice in Prague that deliver us donor corneas, ordered individually for every patient, making sure that we"re getting the best corneas momentarily on the offer with the highest number of endothelial cells, which is the most important criteria for successful outcome of the operation. Age disparity between recipient and donor is aimed to be lower than 20 years.
The successful outcome of the operation depends on many factors where the most important one is the preoperative condition of the recipient"s eye, that is preoperative diagnosis, possible presence and rate of neovascularization and eye inflammation. Surgeon"s experience and skills are of great importance, while after the operation crucial is patient"s cooperation, application of prescribed therapy and early complications recognition. Excellent success rate (>95%) after transplantation have following diseases: keratoconus, inactive leucoma, Fuchs distrophy; very good success rate (80-90%) have pseudophakic bullous keratopathy, interstitial keratitis, macular distrophy; good success rate (50-60%) have herpetic, bacterial or funguos keratitis, keratitis sicca, endothelial distrophy; while low success rate (0-20%) have high-risk cases: previous transplant rejection, chemical trauma, radiation burn, Steven-Johnson"s syndrome.
The most important thing in postoperative process is patience. Corneal transplantation isn"t simple and recovery lasts for months. It is perfectly normal to have blurry sight and for vision to oscillate in the first couple of months, followed by stabilization. But it is to expect that spectacles or contact lenses will be necessary to correct astigmatism developed in the course of cornea stitching. After the operation patient has to make checkups every day for one week, then one time weekly, then 2 times per month, and afterwards one time monthly depending on the previous arrengement with the surgeon. The therapy is also determined individually and in majority of uncomplicated cases, only local drops are required (corticosteroids+antibiotic+artificial tears) several times per day, whereas in complicated cases the system treatment is also prescribed (steroids +/- cyclosporin).
>> An eye with a clear corneal draft
It is our hope that we"ve brought you closer this type of operation. If you have any questions, please feel free to contact us either by phone or by e-mail.
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U skladu s TŰV NORD CERT postupcima.