WHAT TECHNIQUES ARE CURRENTLY USED IN CORNEA TRANSPLANT SURGERY?
The type of cornea transplant depends on the extent of the disease and how much of the cornea needs replacing.
Currently, there are two main techniques:
- Penetrating keratoplasty. Also called full-thickness cornea transplant. It replaces the entire cornea.
- Lamellar Corneal transplantation (lamellar keratoplasty). Also known as partial-thickness corneal transplant. This includes anterior lamellar keratoplasty (ALK) and endothelial keratoplasty techniques.
After a preoperative examination and depending on the condition of the patient’s cornea, your surgeon will decide on the best technique for you.
Endothelial Corneal Transplantation
Thanks to the latest scientific advances, it is possible to do a targeted replacement of diseased corneal layers.
About half of the patients who need corneal transplants have eye conditions that affect the innermost layer of the cornea, also known as the endothelium.
There are two types of endothelial keratoplasty:
The first type, called Descemet stripping endothelial keratoplasty (DSEK), is the most common type of endothelial keratoplasty. It uses healthy donor tissue to replace about one-third of the cornea.
DESK selectively replaces the endothelium– a mere one cell thick -and a thin layer of tissue that protects the endothelium from injury, called Descemet membrane, leaving the overlying corneal tissue intact.
Then, your doctor replaces them with a donor’s endothelium and Descemet membrane still attached to the stroma (the cornea’s middle layer). This allows handling the new tissue without damaging it.
The second type, Descemet membrane endothelial keratoplasty (DMEK), uses a thinner layer of donor tissue. It transplants the endothelium and Descemet membrane without supporting stroma.
In any technique, an air bubble is used to fix the new endothelial layer into place. The microincision is self-sealing, and no sutures are required in most cases.
Endothelial keratoplasty has several advantages over penetrating keratoplasty. These include:
- Less operating time.
- Less aggressive.
- Faster visual recovery with a more comfortable postoperative period.
- No related suture complications.
- Reduced risk of astigmatism after surgery.
- Less chance of transplanted tissue rejection.
NATURAL CORNEAS AND ARTIFICIAL CORNEAS
HOW MUCH DOES A CORNEA TRANSPLANT COST?
Cornea transplant cost depends on the performed technique.
Please, fill in the contact form. If you have any medical reports or examination results from other centers, we would appreciate it if you could send these tests to us by email so we can offer you the solution that best suits your needs.
You can be sure that this information will always be treated with maximum confidentiality.
FAQS ABOUT CORNEAL TRANSPLANT SURGERY
I am a foreign patient. Will the medical personnel at Barraquer speak my language?
Qualified personnel is placed at your disposal, and they will advise you in your language during the hospital process. In case the doctor does not speak your language, a personal interpreter can accompany you throughout all your visits.
How long should it take before the patient can regain vision after corneal surgery?
Visual recovery can be very slow, and medication should be taken over a period of 6 to 12 months. Total cornea transplant recovery time can be up to a year or longer.
What symptoms does corneal rejection cause?
- Decreased vision
- Red eye
- Light sensitivity
How long does the cornea transplant procedure last?
In most cases, it lasts less than one hour. The patient will remain admitted to the Barraquer Hospital for two to three days, depending on their evolution.
Can cornea transplant and cataract surgery be combined in one intervention?
Yes, it is possible.
Are the results permanent?
Across all types of cornea transplants, 75 % last at least five years, and more than 50 % last up to ten years.
BEST CORNEA TRANSPLANT SPECIALISTS AT BARRAQUER EYE HOSPITAL:
External links – Bibliography
Risk factors for graft failure after penetrating keratoplasty. Barraquer RI, Pareja-Aricò L, Gómez-Benlloch A, Michael R.Medicine (Baltimore). 2019 Apr
Comparison of long-term results between osteo-odonto-keratoprosthesis and tibial bone keratoprosthesis. Charoenrook V, Michael R, de la Paz MF, Temprano J, Barraquer RI.Ocul Surf. 2018 Apr;
Epithelial Ingrowth After Descemet Membrane Endothelial Keratoplasty. Álvarez de Toledo C, Salvador-Culla B, López JC, De la Paz MF, Barraquer RI, Álvarez de Toledo J.Cornea. 2019 Sep
Corneal graft failure: an update. Alio JL, Montesel A, El Sayyad F, Barraquer RI, Arnalich-Montiel F, Alio Del Barrio JL.Br J Ophthalmol. 2020 Aug
Osteo-odonto-, Tibial bone and Boston keratoprosthesis in clinically comparable cases of chemical injury and autoimmune disease. de la Paz MF, Salvador-Culla B, Charoenrook V, Temprano J, Álvarez de Toledo J, Grabner G, Michael R, Barraquer RI.Ocul Surf. 2019 Jul
Osteokeratoprosthesis Using Tibial Bone: Surgical Technique and Outcomes. Charoenrook V, Michael R, de la Paz MF, Ding A, Barraquer RI, Temprano J.Ocul Surf. 2016 Oct
Long-term functional and anatomical results of osteo- and osteoodonto-keratoprosthesis. Michael R, Charoenrook V, de la Paz MF, Hitzl W, Temprano J, Barraquer RI.Graefes Arch Clin Exp Ophthalmol. 2008 Aug
Prognostic factors in penetrating keratoplasty. Barraquer RI, Kargacin M.Dev Ophthalmol. 1989
DO YOU WANT MORE INFORMATION ABOUT CORNEA TRANSPLANT SURGERY AT BARRAQUER EYE HOSPITAL?
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If you want a quote, please send a recent medical report.