Corneal Transplant: Causes, Symptoms, Diagnosis, Treatment, and Prevention
During a corneal transplant, a damaged or diseased cornea is replaced with a healthy cornea from a donor. The cornea is the transparent, dome-shaped surface of the eye that helps focus light and allows clear vision. With a corneal transplant, you can improve your vision, reduce your pain, and restore your eye's appearance.
Causes of Corneal Damage
The cornea can be damaged by various conditions, such as:
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Keratoconus, a condition that causes the cornea to thin and bulge outward, creating a cone-like shape.
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Fuchs' dystrophy, a genetic disorder that affects the inner layer of the cornea, causing swelling and clouding.
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Corneal ulcers, sores or infections on the cornea that can result from injuries, contact lens wear, or eye diseases.
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Corneal scars, marks or irregularities on the cornea that can impair vision and affect the eye's appearance.
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Complications from previous eye surgeries, such as cataract removal or laser vision correction.
Symptoms of Corneal Damage
Some of the common symptoms of corneal damage are:
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Blurred or distorted vision.
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Sensitivity to light or glare.
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Eye pain or irritation.
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Redness or inflammation of the eye.
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Decreased vision at night or in low-light conditions.
Diagnosis of Corneal Damage
To diagnose corneal damage, an eye doctor will perform a comprehensive eye exam, which may include:
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Measuring the eye pressure and testing the vision.
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Examining the eye with a slit lamp, a microscope that allows the doctor to see the cornea and other structures of the eye in detail.
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Using a device called a corneal topographer, which creates a map of the cornea's shape and curvature.
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Taking a sample of the corneal tissue for laboratory analysis, if an infection is suspected.
Treatment of Corneal Damage
The treatment of corneal damage depends on the type and severity of the condition, as well as the patient's preferences and expectations. Some of the possible treatments are:
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Medications, such as eye drops, ointments, or oral drugs, to treat infections, inflammation, or allergies affecting the cornea.
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Contact lenses, glasses, or special devices, such as scleral lenses or corneal rings, to correct vision problems caused by corneal irregularities.
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Laser surgery, such as phototherapeutic keratectomy (PTK) or photorefractive keratectomy (PRK), to remove or reshape the damaged corneal tissue.
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Corneal transplant, also known as keratoplasty, to replace the damaged cornea with a healthy one from a donor.
Types of Corneal Transplant
There are different types of corneal transplant, depending on which layer or layers of the cornea are replaced. The main types are:
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Penetrating keratoplasty (PK), also known as full-thickness corneal transplant, which involves removing and replacing the entire central portion of the cornea.
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Deep anterior lamellar keratoplasty (DALK), which involves removing and replacing the outer and middle layers of the cornea, leaving the inner layer intact.
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Endothelial keratoplasty (EK), which involves removing and replacing the inner layer of the cornea, leaving the outer and middle layers intact.
Procedure of Corneal Transplant
The procedure may take 30 minutes to two hours, depending on the type of corneal transplant. The general steps are as follows:
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The eye doctor uses a device called a trephine, a circular blade, to cut out a circular piece of the damaged cornea.
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The eye doctor places a matching piece of donor cornea over the opening and secures it with fine stitches or a special glue.
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The eye doctor covers the eye with a protective shield and applies eye drops or ointment to prevent infection and inflammation.
Recovery from Corneal Transplant
After a corneal transplant, the patient will need to:
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Wear the eye shield for a few days or weeks, as instructed by the eye doctor.
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Use eye drops or ointment for several months, as prescribed by the eye doctor.
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Avoid rubbing or touching the eye, and protect it from dust, wind, and sunlight.
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Avoid strenuous activities, such as lifting heavy objects, swimming, or playing contact sports, for a few weeks or months.
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Visit the eye doctor regularly for check-ups and monitoring of the healing process.
Risks and Complications of Corneal Transplant
A corneal transplant is generally a safe and effective procedure, but it does carry some risks and complications, such as:
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Infection or bleeding of the eye.
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Increased eye pressure or glaucoma.
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Problems with the stitches or the donor cornea, such as loosening, shifting, or wrinkling.
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This can cause vision loss, eye pain, redness, and sensitivity to light. Rejection of the donor cornea is caused by the immune system attacking the new tissue as foreign.
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Retinal problems, such as detachment or swelling.
Prevention of Corneal Damage
Some of the ways to prevent or reduce the risk of corneal damage are:
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Wearing protective eyewear, such as goggles or sunglasses, when exposed to potential hazards, such as chemicals, dust, or UV rays.
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Practicing good hygiene and care when using contact lenses, such as washing hands before handling them, cleaning and storing them properly, and replacing them as recommended.
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Seeking prompt medical attention for any eye injury, infection, or irritation.
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Having regular eye exams to detect and treat any eye problems early.
