The corneal transplantation is performed when medicines, keratoconus conservative surgery and cross-linking cannot heal the cornea anymore.
Role of a Healthy Cornea
Your cornea is a clear tissue that covers the front of each eye. Light entering your eye first passes through the cornea, then your pupil (the dark spot at the center of the colored iris), and then your lens.
The cornea must remain clear for you to see properly. However, a number of problems can damage the cornea, affecting your vision. These include:
Corneal scarring from trauma and infection.
Keratoconus. A degenerative condition in which the cornea becomes thin and misshapen.
Inherited corneal conditions (dystrophies) like Fuchs' dystrophy, Lattice dystrophy, and others.
Types of Cornea Transplants
The cornea contains five layers. Cornea transplants don't always transfer all the layers.
Types of cornea transplants include:
Penetrating (full thickness) cornea transplant. This involves transplanting all the layers of the cornea from the donor.
Lamellar cornea transplant. During this procedure, the surgeon only replaces some of the layers of the cornea with the transplant.
In a lamellar cornea transplant, selected layers are transplanted, which can include the deepest layer, called the endothelium (posterior lamellar cornea transplant). Commonly performed versions of this procedure include Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) or Descemet's Membrane Endothelial Keratoplasty (DMEK).
Or it can include layers closer to the surface (anterior lamellar cornea transplant).
Lamellar transplants may be more appropriate than full penetrating transplants when the disease process is limited to only a portion of the cornea.
Over the years,Success Rates of Cornea Transplants
Experts know more about the long-term success rates of penetrating cornea transplants, which use all the layers of the cornea.
Success rates are also affected by the problem that needed to be fixed with the transplant. For example, research has found that the new cornea lasts for at least 10 years in:
89% of people with keratoconus
73% of people with Fuchs' dystrophy
60% to 70% of people with corneal scarring