Corneal Transplantation (Keratoplasty)

Interesting Facts About the Cornea

Our eyes are surrounded by protective skin, which is transparent at the front of the eyeball and called the cornea. It serves not only to protect the sensitive organ of perception, but also fulfills other functions: It allows light to pass into the interior of the eye and, together with the lens of the eye, is responsible for the refraction of light, which enables us to see our surroundings.

Indications: When is Corneal Transplantation Necessary and Useful?

In general, corneal transplantation is indicated when the cornea is severely clouded by scarring or deformation to the extent that the vision cannot be restored by any other method., which can have various causes. Scarring can result from injuries or inflammation (caused by bacteria, viruses, or fungi). Congenital or acquired degenerative corneal diseases such as keratoconus may also make a transplant necessary under certain circumstances.

If such a disease or injury has been diagnosed, and the decision to receive a transplant was made, the patient will be listed on a recipients' waiting list. As soon as a suitable donor organ is available, the surgery can take place.

Procedure: How Is a Keratoplasty Carried Out?

Donor corneas are obtained from deceased people, which is possible up to 76 hours after their death. As with any organ donation, the consent of the relatives or a valid organ donor card is required. Besides, the deceased must not suffer from a severe infection such as HIV or hepatitis that could be transmitted to the recipient.

Cornea transplantation is by far the most frequently carried out tissue transplantation in Germany. During removal, a part of the cornea from the donor that corresponds precisely to the shape of the cornea required by the recipient is cut out with a laser. This part is then taken to a clinic for the forthcoming surgery. The damaged tissue is removed in surgery under general anesthesia lasting about one hour, and the donor cornea is inserted and sutured under a microscope.

Healing Process of a Corneal Transplant

Follow-up treatment consists of an approximately one-week inpatient hospital stay, and the administration of eye drops, and possibly immunosuppressive drugs to minimize the risk of rejection. After 18 months, the surgical stitches can be removed.

What Are the Risks?

The cornea of the eye usually is free of blood vessels. Therefore, there is typically hardly any rejection reaction, as all the immune cells responsible for this circulate in the bloodstream, which explains why the success rate of more than 90 percent for corneal transplants without complications is very high.

It is more difficult if there was a previous severe inflammation of the eye. One consequence of inflammatory reactions in the body is the sprouting of small blood vessels into the inflamed tissue. In this case, a particularly thorough analysis of the donor and recipient is required to ensure that the genetic characteristics match very well. If a rejection reaction nevertheless occurs, new transplantation is possible.

What Are the Alternatives to Corneal Transplantation?

Recently, there is research in using artificial corneas, but the technique is not yet sufficiently advanced to be used routinely.

Various gentler methods of corneal transplantation have been developed, in which only the diseased partial layers of the cornea are removed.

Which Doctors and Clinics Are Specialists for Corneal Transplantation in Germany and Switzerland?

Anyone suffering from a corneal disease of the eye wants the best medical care. Therefore, the patient is wondering where to find the best clinic for corneal transplantation.

As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on the doctor’s experience. The more keratoplasties are carried out; the more experienced the doctor becomes in his specialty.

Corneal transplant specialists are ophthalmologists who specialize in diseases of the eye’s cornea. Due to their experience and many years of work as ophthalmologists focusing on corneal diseases, they are the right professionals to contact for carrying out a keratoplasty.

Sources:

https://www.unimedizin-mainz.de/augenklinik/patienten/eingriffe-operationen/keratoplastik-hornhauttransplantation.html

https://www.tk.de/tk/krankheiten-a-z/krankheiten-h/hornhauttransplantation/25410