Keratoplasty

"Keratoplasty" article by Nusret Bas, MD for BLUmeditravel

The complete or partial replacement of the frontal transparent layer of the eye (cornea) is called "keratoplasty" or, as it is commonly known, "eye transplant surgery." (With today’s technology, complete eye transplantation is not possible.)

The cornea is a 43-degree lens which allows images to focus on the retina. Because it is the frontal most part of the eye, it is susceptible to accidents that may result in significantly impaired vision.It can be be drilled or cut. During a keratoplasty, the existing cornea that is damaged is replaced by a suitable cadaver cornea. The affected area is approximately 8 mm in diameter.

Other ways the cornea can be damaged include burns—such as acid and alkali burns, lime and hot temperatures—and some corneal diseases present from birth. The need for a cornea transplant (keratoplasty) may also arise in the advanced stage of a very common corneal disease called keratoconus.

In recent years, the most common reason for keratoplasty has been due to corneal damage stemming from intraocular eye surgeries. If the endothelium, which is the innermost layer of the cornea, is damaged during surgery, the cornea loses its transparency. This results in the need for a keratoplasty.

If the superficial parts of the cornea deteriorate and become opaque, a superficial (lamellar) kerataplasty will be performed. There is also a method called endo-keratoplasty, in which only endothelium is transplanted.

Whichever method is performed, keratoplasty is a living tissue transplantation. Thus, a potentially serious complication is the risk of rejection. The rate of rejection is between 5% and 25%, depending on the method used for keratoplasty, the timing of the surgery, the eye’s condition and the patient’s age.

In the case of rejection, the transplant must be performed again.

Keratoplasty surgeries require a high degree of specialization. They cannot be performed by every ophthalmologist or in every hospital.