Penetrating cornea transplant

When the cornea is affected throughout its thickness It is necessary to perform a penetrating keratoplasty, that is, a total corneal transplant.

This operation has a duration of one hour and we do it on an outpatient basis, that is, the patient can go home after the intervention without the need for hospital admission.

Penetrating cornea transplant

When the cornea is affected throughout its thickness It is necessary to perform a penetrating keratoplasty, that is, a total corneal transplant.

This operation has a duration of one hour and we do it on an outpatient basis, that is, the patient can go home after the intervention without the need for hospital admission.

What is penetrating keratoplasty?

El Penetrating corneal transplant or penetrating keratoplasty is a technique to perform corneal transplantation and refers to when we do a complete corneal transplant, and should be performed in patients in which the thickness of the same is affected in its entirety.

This intervention is performed to recover the transparency and regularity of the cornea, and therefore, the vision.

penetrating keratoplasty

Types of corneal transplantation

El cornea transplant o keratoplasty can be:

Penetrating

A penetrating keratoplasty is performed in cases where we replace the cornea completely.

Lamellar or selective

El lamellar or selective corneal transplantation takes place when we only replace the layers of the cornea that are damaged.

In turn, depending on where the lesion is located, there are the following types of lamellar transplant:

Lamellar anterior

It is the technique used when you have to transplant the previous layers of the cornea. Depending on where the injuries are, the following interventions may be performed:

  • Superficial anterior lamellar (SALK).
  • Deep anterior lamellar (DALK).

Posterior lamellar or endothelial

La endothelial keratoplasty is the surgical technique we use to replace the posterior layers of the cornea, which are the deepest (endothelium and / or Descemet), using these techniques:

  • DMEK: consists of transplanting the corneal endothelium selectively.
  • DSAEK: through which the endothelium and Descemet membrane.

How is penetrating keratoplasty performed?

Penetrating keratoplasty is performed through local anesthesia, and the duration of the same is one hour approx.

To do this surgery we carve a central button the size of the damaged cornea that we extract, generally 8,8 mm, and we replace it with a healthy one from a donor, in this case of 8,5 mm, which is sutured with small stitches, which are neither noticed nor seen with the naked eye.

penetrating cornea transplant

After the operation the extracted cornea is analyzed in the microbiology and / or pathology laboratory.

The most common is that the patient is discharged the same day of the intervention. Postoperative controls for penetrating cornea transplantation are scheduled the day after the intervention and a week later. From that moment on, we will organize the regimen of postoperative control visits based on the evolutionary status of the patient. The time of leave due to corneal transplantation usually ranges from two weeks to a month.

Corneal transplant postoperative

During the Postoperative Penetrating Corneal Transplantation, the patient should take a few eye drops to avoid possible complications such as rejection of the implanted tissue. In some cases we will accompany the instillation of drops with oral medication.

Six months after surgery we can proceed to remove the stitches, although they are not usually completely removed until a year after the intervention.

Benefits of a penetrating cornea transplant

After penetrating keratoplasty, it is normal to experience a significant improvement in vision.

Around 75% of patients who have undergone penetrating keratoplasty achieve an improvement in their vision that allows them to drive.

However, in some cases glasses or contact lenses are needed, or even complement it with another intervention such as cataract surgery or glaucoma, to recover the highest possible visual quality.

Penetrating keratoplasty risks

Like any operation, penetrating keratoplasty has a number of riesgos:

Rare complications

Although they are rare but serious, there are certain problems that can occur such as:

  • Infection that compromises vision (in 1 out of every 1.000 cases).
  • Retinal detachment.
  • Severe inflammation.
  • Severe bleeding leading to loss of vision.

Sight loss

In some cases, a penetrating corneal transplant can lead to vision loss, such as if the graft is rejected.

This is something that happens to 1 in 6 patients during the first years after the operation, although it must be taken into account that this rejection is usually due to the fact that the patient suspends the anti-rejection medication without the doctor having indicated it.

However, the possibility of graft rejection, due to graft failure or aging, continues to exist. throughout the patient's life. In fact, it occurs in 1 in 10 transplants during the 10 years after transplantation.

Glaucoma

There are patients who suffer from glaucoma after having undergone a penetrating corneal transplant. Usually this complication can be controlled by applying a few drops to reduce intraocular pressure, although in the most severe cases it may be necessary to perform a glaucoma surgery.

Cataract

In some cases, the appearance of cataracts can be anticipated after penetrating keratoplasty. The solution is to perform cataract surgery.

Summary
Find out what penetrating keratoplasty is and what benefits it brings
Article name
Find out what penetrating keratoplasty is and what benefits it brings
Description
Penetrating keratoplasty is the transplant of the complete cornea, and it should be performed in patients in whom the thickness of the cornea is completely affected.
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Área Oftalmológica Avanzada
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