The cornea is the only structure of the eye that can be successfully transplanted for visual restoration. Currently, cornea transplant has undergone may advances and involves layer by layer transplants, which have highly increased the success chances of this operation.
In this procedure, the blood of the deceased donor is first screened for transmissible diseases like HIV/HCV etc. After this the donor cornea undergoes a “Specular Microscopy” which is a test to analyse the health of the cells of the donated cornea tissue. Based on the result, the donors can be divided for various uses.
A THERAPEUTIC KERATOPLASTY
is a type of cornea transplant that is performed for patients with massive cornea infections which have not come under control with drops, or which have potential to spread deeper and damage the entire eye.
Corneal full-thickness Therapeutic Transplant done for a fungal corneal infection
In this procedure, the diseased cornea is replaced with a donor cornea for the purpose of only controlling the corneal infection. The patient may require a second surgery for visual correction.
is a corneal transplant that is solely done for the visual function of the patient.
Cornea transplants can further be divided into full-thickness or Partial-thickness (LAMELLAR) surgery. This is based on the layer of the cornea that is damaged and replaced.
In full thickness or Penetrating Keratoplasty, the entire diseased cornea is removed and replaced with donor tissue of full thickness of the corneal button.
surgeries are advanced surgeries, where only the damaged tissue is replaced. i.e. either only the front of the cornea or the back of the cornea. This basically means that one donor cornea can be used for 2 different surgeries and help 2 individuals gain sight !
DALK- Deep Anterior Lamellar Keratoplasty
is a cornea transplant surgery that involves removing only the front damaged layers of the cornea and the back remains the patients own layer.
DSEK- Descemet’s Stripping Endothelial Keratoplasty
is a cornea transplant surgery where only the last damaged layer of the eye is replaced, the front layers are the patient’s own.
The cornea transplant cost is higher for lamellar surgery because of the surgeon skill and equipment used to get better results. These surgeries are preferred since they reduce chances of cornea rejection after transplant surgery.
Dr Kareeshma Wadia has done a super speciality in this field and spent 2 years in Bangalore at Narayana Nethralaya Superspeciality Eye Hospital to master the art of these cornea transplant surgeries.
We cannot emphasize more on the need to donate your eyes, and not bury/burn them. Eye donation can be done within 6 hours after the death of a person. All you need to do is contact your nearest eye bank/ the hospital in which the death has occurred and they will do the needful.
To restore the vision of a person with a damaged cornea, a corneal transplant surgery is executed.
In any organ transplant, there is always the risk of rejection, this can be reversed with eye drops most of the time.
There are different types of transplants. A lamellar advanced procedure may recover in 4-5 weeks. It can take up to a year to fully recover from a full-thickness corneal transplant. With the exception of heavy lifting, most people are back to their normal practices and lifestyle within one to two months.
There are different types of transplants. It may take six to twelve weeks for the patient to get the full benefits of the procedure and to be able to see clearly. The doctor will prescribe certain eye drops to help you heal post-surgery and prevent your body from rejecting the donor organ. Vision may be blurry for a certain period of time post-surgery.
A corneal transplant is a fairly safe procedure. Patients have stated that after a corneal transplant, their day-to-day activities had enhanced as an outcome of better eyesight. So yes, one can lead a normal life after a cornea transplant as long as they follow the doctors’ instructions for post-surgery aptly.
To become a cornea donor, one has to inform their next of kin and immediate family regarding their choice. In the case of a hospital death, the hospital authorities need to be informed, and they will arrange to execute the eye donation. If a death happens at home, you need to call the nearest eye bank and they will visit the house to collect the cornea. You can also register and add your name to the EBAI Organ Donor Register and inform your immediate family about their decision.
Corneal transplant surgery is performed under local anesthesia. There maybe pain after the procedure, for which your Doctor will prescribe pain killers. You should continue using the eye drops prescribed by your doctor which will help reduce inflammation and also lower the chances of infection
Based on the type of procedure done, the success rate varies. Most lamellar surgeries are more successful. But as it is an organ transplant surgery there is always a small risk of complications, such as rejection of the donor cornea.
NO. Corneal transplant surgery is always done on one eye at a time.
All the surgeries are day care procedures. You may have to wait for a few hours after the procedure at the hospital, but will be discharged the same day.
Certain instructions provided by the doctor must be followed they are as follows:
During the first few weeks’ post-surgery avoid heavy exercises or heavy lifting.
Do not rub your eyes
Avoid places or activities which have or can produce dust as that could cause irritation to the eyes.
Avoid contact sports and swimming, at least until your doctor says it is safe for you.
You will be prescribed eye drops post-surgery which you must continue to put for the prescribed duration as it will help in reducing the inflammation.
In certain cases, corneal rejection can happen. Rejection happens when our immune system recognizes that the donated cornea does not belong to our body and attacks it. Rejection can happen after a few months of the procedure or it can sometimes also happen just a few weeks later.
This can often be treated effectively with steroid eye drops.
For Keratoconus, the Corneal collagen cross-linking (C3R / CXL) procedure is an FDA-approved first line of treatment, it can preserve vision and prevent further progression of the disease which if worsened could lead to the need for a corneal transplant. Scleral contact lenses can also be tried for patients as a last resort. For those people whose vision does not improve by any other options, the transplant may be the last option.
But otherwise, it depends on the underlying cause.
The follow-up visit with your doctor usually happens 24 to 48 hours post-surgery. They will remove your eye patch dressing and check on your eye recovery.
You will be prescribed eye drops and ointments to reduce swelling prevent infection and also prevent the chances of rejection.
Depending on the type of operation that you have undergone, you may or may not have to have stitches removed. The doctor will recommend that you wear glasses or other protective eyewear for some time.
Yes, the very first artificial 3D-Printed Human Cornea in India has been developed by the L V Prasad Eye Institute, Center for Cellular and Molecular Biology and Indian Institute of Technology Hyderabad.
The average cost for a corneal transplant varies from approximately Rs. 50,000 to Rs.1,50,000 per eye, based on the type of procedure and whether associated with the laser.
The cornea is like the windscreen of your car. It is the very first clear part of the eye that covers the pupil. It protects the inner eye and also focuses light that passes through to the eyes’ lenses and retinas. Without this focus, when the light passes through the front of the eye, it cannot land precisely on the retina, which in turn leads to blurry vision.
Over our entire life span, there are certain bodily changes that transpire. These include changes in corneal toxicity, sphericity, thickness, tactile sensitivity, and a variety of aging changes.
Insurance companies in India today, mostly offer organ transplantation surgeries as part of their regular health coverage plan. Some health plans cover the entire cost, while some cover the surgery partially. It is best to go through your health insurance plan thoroughly before making any major decisions.
The overall cost of a corneal transplant can be considerably reduced depending on your health insurance coverage and terms and conditions. Insurance companies in India today, mostly offer organ transplantation surgeries as part of their regular health coverage plan. Some health plans cover the entire cost, while some cover the surgery partially. It is best to go through your health insurance plan thoroughly before making any major decisions.