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About The Transplant

What is Corneal Transplant?
The cornea is the dome-shaped clear structure at the front of the eye. It plays a critical role and along with the eyelid, eye socket, the sclera and tears protect the eye from germs, dust, and other foreign particles. It also permits light to enter the eye.
The cornea is entirely composed of a particular type of collagen. It does not contain blood vessels, but any damage to the cornea can be very painful due to the presence of nerve endings. Though the corneal tissue can heal minor injuries quickly, deep injuries are prone to cause permanent damage to vision. A corneal transplant, also known as keratoplasty, helps to restore or dramatically reset the vision in an injured or damaged cornea. Through this surgical procedure, the damaged or diseased tissue is replaced with healthy corneal tissue which is taken from a donor who is deceased recently.

Corneal transplant or corneal grafting involves the replacement of the damaged or diseased cornea with donated corneal tissue – the graft, and may be of two types:

  • Penetrating keratoplasty – the replacement of the entire cornea
  • Lamellar keratoplasty – replacement of only a part of the cornea

Since many people register and donate their corneas to be used after their death, the waiting period for a corneal transplant is not as long as the waiting period for other organ transplants. The tissue comes from an eye bank and is tested to make sure it is safe for the recipient before it is transplanted. If not, then the recipient is considered for an artificial corneal transplant. Though the outcome of donor tissues is best for the majority of the people undergoing the surgery, artificial transplant proves to be more successful in cases of severe ocular surface disease or in cases where there has been more than one failed graft previously.

Indications for Corneal Transplant
Any injury to the cornea leads to swelling or scarring as a result of which it may lose its smoothness and clarity. The scars, swelling or the irregular shape causes the cornea to distort or scatter light thus leading to a glared or blurred vision. A corneal transplant is considered only when the cornea is severely damaged, and vision cannot be satisfactorily corrected with contact lenses or eyeglasses and medicines or special contact lenses are unable to relieve the painful swelling and heal the cornea. The procedure helps to repair or dramatically restore vision in eyes which have damaged or diseased cornea.  

  • A corneal transplant surgery helps to correct the following:
  • Fuch’s dystrophy – the degeneration of the innermost layer of the cornea
  • Lattice dystrophy
  • Keratoconus – an outward bulging cornea
  • Pseudophakic bullous keratopathy – painful swelling of the cornea 
  • Pterygium – growth of tissue on the cornea
  • Stevens-Johnson syndrome – skin order that affects the eye
  • A corneal ulcer which may be due to trauma like a scratched cornea

Some of these conditions may lead to the clouding of the cornea while others may alter the natural curvature of the cornea reducing the vision quality.

  • The cornea may also suffer injury from mechanical trauma, chemical burns or infection from bacteria, virus, fungus or protozoa. One of the most common infections which require corneal transplant is produced by the herpes virus.
  • Though cornea is not vascular, some corneal diseases may cause vascularization – the growth of blood vessels into the cornea. For such patients, careful testing of both donor, as well as the recipient, is done. These patients often have to undergo repeat surgery for a successful transplant of the cornea.
     

Contraindications 
People with some specific medical conditions are not eligible for eye donation. The following lists some general contraindications in a donor’s medical history that limits or prevents donation of the cornea:

  • Infectious or potentially communicable diseases such as
  • Active viral Hepatitis
  • Active viral encephalitis or encephalitis which is of unknown origin
  • Acquired immunodeficiency syndrome – AIDS or HIV
  • Rabies
  • Active septicemia (fungemia, bacteremia or viremia)
  • Subacute sclerosing panencephalitis (measles)
  • Central Nervous System disorders such as
  • Alzheimer’s
  • Parkinson’s disease
  • Multiple Sclerosis – MS
  • Amyotrophic lateral sclerosis – ALS
  • Other CNS diseases
  • Malignancies such as
  • Leukemia or lymphoma
  • Lymphosarcoma
  • Hodgkin’s disease

Most other types of cancer are accepted for a donation of the eye.

  • Intrinsic eye disorders such as
  • Retinoblastoma
  • Corneal scarring
  • Ocular inflammation
  • Laser photoablation surgery
  • Malignant tumors of the anterior segment

Glaucoma and cataracts are accepted for eye donation.

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