Keratoplasty

Saturday, September 4, 2010

Keratoplasty, also known as corneal transplantation, is a surgical procedure where a damaged cornea is replaced by donated corneal tissue (the graft) in its entirety (penetrating keratoplasty) or in part (lamellar keratoplasty). The graft has been removed from a recently deceased individual with no known diseases or other factors that may affect the viability of the donated tissue or the health of the recipient. The cornea is the transparent front part of the eye that covers the iris, pupil and anterior chamber. The surgical procedure is performed by ophthalmologists, medical doctors who specialize in eyes, and is often done on an outpatient basis.

Penetrating keratoplasty

A trephine (a circular cutting device) is then placed over the cornea and is used by the surgeon to cut the host cornea, which removes a circular disc of the patient cornea. The trephine is then removed and the surgeon cuts a circular graft (a "button") from the donor cornea. Once this is done, the surgeon returns to the patient's eye and removes the host cornea.

The donor cornea is then brought into the surgical field and maneuvered into place with forceps. Once in place, the surgeon will fasten the cornea to the eye with a running stitch (as used in the upper image above) or a multiple interrupted stitches (as in the lower image). The surgeon then reforming the anterior chamber with a sterile solution injected by a cannula, then testing that it's watertight by placing a dye on the wound exterior.

Antibiotic eyedrops placed, the eye is patched, and the patient is taken to a recovery area while the effects of the anesthesia wear off. The patient typically goes home following this and sees the doctor the following day for the first post operative appointment.