Traditional keratoplasty is a procedure that removes and replaces the cornea with donor tissue. In recent years, less invasive procedures, which remove only selected portions of corneal tissue, have also been perfected.
Types of Keratoplasty Procedures
Keratoplasty is a relatively low-risk surgical procedure. It is the most common type of transplant surgery currently performed and has the highest rate of success. There are several different corneal transplant methods available to help restore vision in patients with corneal problems.
Penetrating Keratoplasty
Penetrating keratoplasty is the traditional method used for corneal transplantation where the central two-thirds of the damaged cornea is surgically removed and replaced with a healthy cornea from a human donor.
Deep Anterior Lamellar Keratoplasty
Deep anterior lamellar keratoplasty, also known as DALK, removes only the outermost layers of the cornea, while preserving the healthy, well-functioning inner layers, known as Descemet’s membrane and the endothelium. New laser technology used in a DALK procedure reduces the likelihood of scarring or irregularities in shape that might impair vision.
Endothelial Keratoplasty
Endothelial keratoplasty, of which there are several types (DSAEK, DSEK and DMEK), is a surgical procedure that removes the abnormal inner lining of the cornea, known as the endothelium. Endothelial keratoplasty requires much smaller incisions than a penetrating keratoplasty, resulting in fewer risks and a shorter recovery time.
Corneal transplants are usually performed with patients under local anesthesia. While there is some chance of graft rejection or the failure of donor tissue to attach properly to the patient’s own tissue, in the less invasive procedures, this risk is greatly reduced. In these less invasive, shorter surgeries, there is also less scarring and and a shorter recovery period.
Reasons for Keratoplasty
Conditions that may require a corneal transplantation include the following:
- Corneal scarring
- Keratoconus
- Inherited corneal disorders, like Fuchs’ dystrophy
- Infections of the eye
- External tumors or pterygia
- Irreversible cornea edema
- Corneal ulceration, erosion, thinning, or perforation
The most common reason for performing a keratoplasty is to improve diminished vision. More rarely, the surgery is performed to treat a chronic corneal infection. In extremely rare cases, the operation is performed for cosmetic reasons, when corneal scars have affected the appearance of the eye.
Types of Keratoplasty Procedures
Keratoplasty is a relatively low-risk surgical procedure. It is the most common type of transplant surgery currently performed and has the highest rate of success. There are several different corneal transplant methods available to help restore vision in patients with corneal problems, all of which are usually performed under local anesthesia.
Penetrating Keratoplasty
Penetrating keratoplasty is the traditional method used for corneal transplantation in which the central portion of the damaged cornea is surgically removed and replaced with a healthy cornea from a human donor. While a very effective surgery for vision correction, this procedure carries greater risks of graft rejection than the partial corneal transplantations.
Deep Anterior Lamellar Keratoplasty
Deep anterior lamellar keratoplasty, also known as DALK, removes only the outermost layers of the cornea, while preserving the healthy, well-functioning inner layers, known as Descemet’s membrane and the endothelium.
Endothelial Keratoplasty
Endothelial keratoplasty, of which there are several types (DSAEK, DSEK and DMEK) is a surgical procedure that removes the abnormal inner lining of the cornea, known as the endothelium. Endothelial keratoplasty requires much smaller incisions than a penetrating keratoplasty, resulting in fewer risks and a shorter recovery time.
Keratoplasty is generally a safe and effective repair treatment. While there is some chance of graft rejection, even in the less invasive procedures, keratoplasty is generally a safe and effective repair treatment.
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