Traditional Graft Techniques

Penetrating Keratoplasty ( Full thickness graft)

This is the traditional method of performing a corneal transplant and involves replacing the diseased cornea with a donor cornea. The donor cornea is sutured into place. Some sutures are removed over a 3-6 month period to minimise induced astigmatism. The remaining sutures are removed after 12-18 months.Whilst the procedure is relatively straight forward to perform, there are drawbacks when compared to other procedures:

Visual rehabilitation

It can take 18 -24 months before vision stabilises because

full thickness corneal tissue takes a long time to heal and

settle into position.

Astigmatism

Traditional grafts involve a large number of sutures. Each suture places variable tension on the corneal site, which can cause astigmatism, or irregularities, in the way light is refracted.

To reduce induced astigmatism, some sutures are removed over 3-6 months. It is quite common for patients to need a powerful spectacle or contact lens correction after the operation.

Graft rejection

The immune system can sometimes reject transplanted tissue. If this happens the endothelial cell layer will be affected and vision becomes cloudy. The endothelium is the main site susceptible to rejection. The risk of rejection can be reduced by the use of steroid drops for 6-12 months following the operation.

Deep Lamellar Endothelial Keratoplasty ( DLEK)

This involves replacing a layer of donor corneal stroma together with the endothelial cell layer. This ' button' is transplanted into the recipient cornea. Visual recovery is faster than with traditional ' full depth' grafts and good vision is attainable within 3 months.

Deep Anterior Lamellar Keratoplasty ( DALK)

This is usually performed for corneal scarring, stromal dystrophies or keratoconus. These conditions require replacement of the anterior part of the cornea. The patient's own endothelium can often be preserved, thus minimising the risk of rejection. Sutures can be removed after 6 months and visual recovery is faster than with traditional grafts.

Unfortunately astigmatism can be induced, requiring spectacle or contact lens

correction.

Post Op Care.

Website Designed & Produced by  OptimEyes UK Ltd