Keratoplasty surgeries, also known as corneal transplant surgeries, are procedures performed to replace damaged or diseased corneal tissue with healthy donor tissue. These surgeries are crucial in treating a variety of corneal conditions that can affect vision and overall eye health.
Penetrating Keratoplasty (PK): In PK, the entire thickness of the cornea is replaced with donor tissue. This surgery is typically performed for conditions such as corneal scarring, corneal dystrophies, or corneal infections that affect the entire cornea. During the procedure, a circular section of the patient's cornea is removed and replaced with a similarly sized donor cornea. Sutures are used to secure the donor tissue in place while it heals.
Lamellar Keratoplasty (LK): Lamellar keratoplasty involves replacing only the affected layers of the cornea, leaving healthy layers intact. This technique is used when the disease or damage is limited to specific layers of the cornea, such as in conditions like keratoconus or corneal stromal dystrophies. LK techniques include deep anterior lamellar keratoplasty (DALK), where only the front layers of the cornea are replaced, and endothelial keratoplasty, which targets the innermost layer of the cornea.
These keratoplasty surgeries can be further categorized based on the source of the donor tissue:
Allograft: Donor tissue obtained from a human cadaveric eye is used for most keratoplasty surgeries. The donor cornea is carefully screened and processed to ensure compatibility and reduce the risk of rejection.
Autograft: In rare cases, such as in patients with severe ocular surface disease, tissue from another part of the patient's own body may be used for transplantation.
Keratoplasty surgeries are typically performed under local or general anesthesia, depending on the patient's age and medical condition. Following surgery, patients undergo a period of recovery, during which they are monitored closely for signs of graft rejection or complications. Long-term follow-up is essential to assess the success of the transplant and manage any potential issues that may arise.
Overall, keratoplasty surgeries are highly effective in restoring vision and improving the quality of life for patients with corneal conditions. These procedures have evolved significantly over the years, with advancements in surgical techniques and immunosuppressive medications leading to improved outcomes and reduced risks of rejection.