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Cornea Transplant

Home Cornea Transplant

Cornea Transplants

The cornea is the clear, front part of the eye that focuses light onto the retina to ensure clear vision. For good vision, the cornea must be clear, smooth, and healthy.

When the cornea is scarred, damaged, or diseased, it loses its ability to properly focus light, causing blurry or distorted vision. If medications or non-surgical treatments are not effective in restoring corneal health, your ophthalmologist may recommend a corneal transplant using tissue from a human donor.

Source of Donated Corneas

In Egypt, most donated corneas are imported from the United States. These corneas undergo rigorous testing to ensure they are free of diseases and meet the highest safety and quality standards. The process complies with the standards set by the Eye Bank Association of America (EBAA).

Types of Corneal Transplants

The type of corneal transplant depends on the extent of damage and which part of the cornea is affected. The main types are:

  1. Full Thickness Cornea Transplant (PKP – Penetrating Keratoplasty):
  • Recommended when all layers of the cornea are damaged.
  • The entire cornea is replaced with healthy donor tissue.
  • This is typically used for severe cases involving scarring or complete corneal damage.
  1. Partial Thickness Cornea Transplant (DALK – Deep Anterior Lamellar Keratoplasty):
  • Used when damage is limited to the front and middle layers of the cornea, such as in early to moderate keratoconus.
  • The inner layer (endothelium) is preserved, reducing the risk of rejection compared to a full transplant.
  1. Endothelial Cornea Transplant (DMEK or DSEK):
  • Recommended when only the inner layer (endothelium) is damaged, such as in cases of endothelial dystrophy or chronic swelling.
  • This procedure involves replacing just the damaged inner layer.
  • Although technically more complex, it has a lower risk of rejection and a faster recovery compared to full-thickness transplants.

Choosing the Right Surgery

Your ophthalmologist will determine the appropriate type of corneal transplant based on a thorough examination and diagnostic tests. The doctor will explain the condition and surgical plan in detail to ensure you understand the procedure and post-operative care.

Common Causes for Corneal Transplants in Egypt

  1. Trauma or Infections leading to corneal scarring.
  2. Keratoconus, where the cornea becomes progressively thinner and more cone-shaped.
  3. Complications from Previous Eye Surgeries that damage the cornea.

Procedure and Anesthesia

  • Corneal transplants are typically performed as an outpatient procedure, meaning you can go home the same day.
  • The surgery is done under local or general anesthesia, depending on your condition and the surgeon’s recommendation.
  • In some cases, cataract surgery can be performed simultaneously to optimize visual outcomes.

Post-Operative Care Instructions

Following the doctor’s instructions after surgery is critical to ensure a successful recovery. Key post-operative guidelines include:

  1. Use Eye Drops Regularly:
  • Follow the prescribed schedule for antibiotic and anti-inflammatory drops to prevent infection and reduce inflammation.
  1. Avoid Eye Pressure or Rubbing:
  • Do not press on or rub your eye to prevent damage to the new corneal graft.
  1. Limit Physical Strain:
  • Avoid lifting heavy objects or bending excessively to prevent increasing eye pressure.
  1. Protect the Eye:
  • Wear protective glasses to shield your eye from dust, injury, or impact.
  • Avoid getting water in the eye during bathing or swimming until cleared by your doctor.
  1. Sleep Position:
  • Avoid sleeping on the operated side. Your doctor may recommend wearing an eye shield while sleeping.
  1. Attend Follow-Up Appointments:
  • Regular follow-ups are essential for monitoring healing and detecting any complications early.
  • Even if you travel abroad, continue your follow-up care and coordinate with your doctor for long-term management.
  1. Monitor for Complications:
  • Contact your doctor immediately if you experience severe pain, sudden redness, vision loss, or unusual discharge.

Recovery Period

  • Full recovery can take between 6 months to a year or longer, depending on the type of transplant and your eye’s healing response.
  • Partial transplants (DALK or DMEK/DSEK) often have a shorter recovery time compared to full-thickness transplants (PKP).

Potential Complications

  1. Graft Rejection:
  • Occurs when the body’s immune system attacks the donor tissue.
  • Rejection affects approximately 10-20% of patients.
  • Symptoms include:
  • Redness
  • Blurry vision
  • Sensitivity to light
  • Eye pain
  • Early detection and prompt treatment with steroids or immunosuppressive drugs can often reverse rejection.
  1. Graft Failure:
  • In some cases, the corneal graft may fail due to chronic rejection, infection, or poor healing.
  • A repeat transplant may be necessary, though the success rate for a second transplant is typically lower than the first (about 60-70%).

Important Notes

  • Consistent follow-up with your ophthalmologist is essential for detecting and managing any complications.
  • Adhering to post-operative care instructions significantly increases the likelihood of a successful outcome.