Corneal Transplant
Among all the cell and organ transplants, the cornea transplant surgery is the most widespread worldwide. Thanks to it, many people who are visually-impaired or blind regain their normal vision. As a matter of fact, the cornea is made mainly of collagen, water and cells, it is a complex part of the eye, having a primordial role for the vision. The corneal transparency and curvatures can be altered with age, because of traumatic accident, chemical burns, corneal degeneration, or inflammations such as keratitis especially herpetic keratitis, or following an operation. As a result, this leads to a decrease in visual acuity, or even the loss of vision. In these cases, a corneal transplant may be recommended. Corneal implant or keratoplasty can be performed at any age, even at 90 years old. It consists of replacing the sick cornea with a healthy and transparent one taken several days earlier from a deceased donor either in its full thickness penetrating keratoplasty (PK), or only partially lamellar corneal transplant, depending on the pathology. Many examinations are carried out to be sure of the good quality of the implant and its harmlessness with respect to the cornea receiver.
Read more about eye surgeries:
- Laser eye surgery
- Refractive lens exchange surgery
- Cataract surgery
Corneal Transplant price
The price of a Corneal Transplant in Tunisia coupled with a week of recovery or vacation in a 5 stars hotel is at least % cheaper than the sole procedure in Europe and for the same medical quality.
How is corneal transplant surgery performed?
Given that precision is required for this type of intervention, corneal transplantation is performed under an operating microscope and under local or general anesthesia depending on the patient's age, their ability to collaborate, and the length of the intervention. If both eyes are affected, they must be operated separately, about one year apart because simultaneous corneal implantation increases the risk of rejection. This procedure is not carried out using a laser, but with very specific tools which allow an extremely precise lamellar cut, in particular a microkeratome.
Indeed, there are two types of corneal transplants. The traditional corneal transplant surgery, also known as penetrating keratoplasty (PK), replaces the full thickness of the diseased corneal tissue by a healthy one that protects the endothelium. The intervention lasts about 40 minutes. This is the classic surgical method used in the event of contact lens failure, when the patient cannot obtain useful vision with their contact lenses because of central or paracentral opacity or an intolerance to the lens contact. The Anterior lamellar keratoplasty (ALK), consists of only replacing the part of the cornea that is sick. It is about lamellae with different thicknesses. If the diseased part is located in front of the cornea keratoconus for example, a so-called anterior lamellar keratoplasty is performed.
Scars related to corneal transplant surgery
The sutures are stitched up by continuous sutures, separate points, or a combination of both. In all cases, the knots are hidden within the cornea to avoid irritation of the cornea’s surface. In fact, the interest of the separated points is to be able to remove them progressively later, and to better reduce astigmatism.
The advantage of the overlock stitch is that it ensures a more even distribution of forces on the circumference of the cornea, and makes it possible to obtain a more regular astigmatism. As for the healing of the corneal transplant, it is very slow and it takes about 5 years to fully heal. The stitches are left in place for one year on average, however, they can be removed if they loosen up and cause inflammation or in case they are too tight.
Postoperative effects and recovery after corneal transplant surgery
The hospitalization lasts two days and then the patient can return back home. Regarding the postoperative treatment, it consists of anti-inflammatory and anti-rejection drops. In fact, the postoperative effects are not painful, but sometimes the patient may experience a feeling of discomfort such as sensitivity to light, tearing, and difficulty opening the eye. Besides, an eye shield protection without bandage is placed during the first ten nights, and sunglasses can be worn if needed during the day. In addition, violent sports, are strongly prohibited the first period. While, the daily tasks will be reduced during the first weeks, until the scar has reached a certain solidification. The surgeon will prescribe to the patient to take 8 to 21 days off. And the most important thing, it is essential to consult a specialist in case of redness or pain of the eye because it can be symptoms of rejection.
Result and outcome after corneal transplant surgery
The useful vision in daily life reappears after a few days. But the precise visual acuity returns gradually. Indeed, fully acute vision is only obtained after nine to twelve months on average. The patient will be followed very regularly for up to two years.
The grafted cornea never regains more than 60% of the original cornea's mechanical strength, so it is very important for the patient to avoid eye bruising for the rest of their life. Final visual recovery varies from one person to another.
Advices after Corneal transplant surgery
After corneal implantation, the patient should never rub their eyes for at least 10 days following surgery, even in case of tingling or tearing. During the first 8 nights and even during naps, it is imperative to put the eye shield and avoid exposure to dust and projections such as spray, shampoo. . When outside, it is advised to wear eye glasses for the first 15 days. The patient should follow scrupulously the post-operative treatment. Indeed, they have to gently instill the prescribed drops, without allowing any contact between the bottle and the eye and without touching the upper eyelids. After a corneal transplant, the patient must go to the appointments fixed by their surgeon in order to examine the transplanted cornea after the intervention. Swimming in the pool or in the see is totally forbidden for the two weeks following the surgery. Meanwhile, it is recommended to stop any risky sports such as football and box as well as diving for at least 2 months.