The cornea is a transparent layer in the front of the eye positioned just opposite the iris, the “colored part of the eye”. Corneal transplantation or “keratoplasty” is a surgery in which an opaque cornea is replaced by a transparent cornea.
Corneal transplantation is a surgical procedure in which the damaged cornea is removed, replaced by a new, healthy cornea.
Corneal transplantation is done in two common ways:
Full thickness cornea transplant
In this case, the whole thickness of the cornea is removed in the affected area and replaced by a healthy cornea.
Back layer cornea transplant
Corneal transplantation has been in use since about 40 years ago, in which a damaged or diseased cornea was removed and a healthy cornea was grafted. Gradually, with the development of ophthalmology and the development of new surgical methods, corneal transplantation was transformed, and the surgeons only succeeded in removing the affected part of a damaged cornea and attaching the healthy layer of a donated cornea instead.
Deep Anterior Lamellar Keratoplasty (DALK)
This surgical method is used when the patient has wide disorders in the surface and upper layers of the cornea.
Descemet Stripping Automated Endothelial Keratoplasty (DSAEK)
This surgical method is used when the patient suffers from corneal endothelium (on the inner surface of the cornea) disorder and the superficial and intermediate parts of the cornea remain healthy. The thickness of this bonding layer is about 90 to 180 microns.
Reasons for Keratoplasty
۱٫ Make better vision in cases where corneal opacity leads to blurred vision.
۲٫ Repairing corneal perforations to protect the internal structure of the eye sphere
۳٫ Treating severe pain which is caused by a disease or corneal edema (swelling of the cornea)
۴٫ Eradicating corneal infection that is not treated by the medications
The transplanted corneas after death are removed from the eyes of people who were willing to help others by cornea donation. All corneas donated in Iran are kept at the Eye Bank of the Islamic Republic of Iran. All donated corneas are also controlled for diseases such as AIDS and hepatitis to prevent the transmission the diseases to corneas recipients. Approved corneas are stored in Iran’s Eye Bank for 2 to 8 days.
For corneal transplantation surgery, the patient usually should be admitted to Naviddidegan Eye Clinic. The Clinic communicates with the Eye Bank for reserving the cornea. During the surgery, the surgeon uses a special microscopic instrument to remove a round section of the defective cornea from the patient’s eye and replaces it with a similar round section of the healthy donated cornea. After placing the donated cornea in the patient’s eye, the surgeon stitches it into the place with an ultra-fine thread.
After surgery, your eye is at first very vulnerable to blows on it, you must be careful not to touch or press your eye. Because even a small blow may damage it seriously. Therefore, it is necessary to wear a protective plastic eye shield during the first weeks after the surgery, so that it does not hit the eye. During this time avoid bending down, pushing, lifting heavy objects or bending your head forward. If you have to pick things up from the floor, don’t bend your waist, just bend your knees and keep your head up. When you wash your hair, make sure that the water and shampoo do not enter your eyes. Heavy exercises are prohibited. Don’t take any more physical exercise than a brisk walk after the surgery. Above all, avoid rubbing and poking your eyes during this period.
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