In today's world there is a rapid development of medicine. Achievements are observed in all areas. This applies to surgical and therapeutic methods of treatment, diagnostics, and scientific discoveries. Ophthalmology is no exception. With the advent of microsurgical techniques, eye surgery has become much safer and more effective. The advantages of modern ophthalmology are a quick and painless restoration of vision. Eye cornea transplantation, which previously seemed impossible, is now carried out in all specialized centers. As a result of keratoplasty, many people regain the ability to see the world around them.
Corneal transplant – what is it?
This operation has a scientific name - keratoplasty. It is also called corneal transplantation. Since this organ of vision does not have a blood supply, in most cases it takes root and the operation is considered successful. After keratoplasty, vision is significantly improved or completely restored. Donor transplantation of the cornea of the eyes is mainly common. The damaged parts or the organ as a whole are replaced. In some cases, transplantation is performed with artificial material. Most often, this operation takes place under general anesthesia. Nevertheless, some experts recommend doing keratoplasty with local anesthesia. The effectiveness of the operation is observed almost always, and complications after corneal transplantation are extremely rare. For these reasons, keratoplasty is a sought after treatment worldwide.
When is a corneal transplant performed?
Corneal transplant surgery is performed only under strict indications. In most cases, trauma and inflammatory diseases are the cause of organ damage. In both cases, there is a significant deterioration in vision or a complete loss of visibility (less often). Sometimes keratoplasty is performed for cosmetic purposes. The following reasons are distinguished for which the operation is performed:
- An eyesore. The causes can be both dystrophic diseases and injuries of the organ of vision.
- Retinopathy. This refers to those forms that are not amenable to therapeutic treatment. These include dystrophic, bullous retinopathy.
- Injury to the cornea. May occur when various foreign bodies get into the eye.
- Chemical burns.
- Thinning of the corneal layer. It is observed in a disease such as keratoconus.
- Ulcerative and erosive defects.
- Scars.
- Corneal clouding. Usually the result of laser procedures.
- Cosmetic defects.
Contraindications for keratoplasty
In most cases, eye microsurgery is an area of medicine that is widely accessible. Contraindications to eye surgery are rare. Keratoplasty is performed for everyone who has the listed defects. There are no age restrictions for this operation. Nevertheless, there are 3 conditions in which keratoplasty is prohibited. These include:
- An eyesore that have a blood supply. The presence of vessels makes corneal transplantation ineffective.
- Combination of cataracts and increased intraocular pressure (glaucoma).
- Comorbidities with a high chance of transplant rejection. These include immunological pathologies, decompensated diabetes mellitus.
What are the types of keratoplasty
Like most operations, keratoplasty can be performed in different ways. It depends on the type of transplant (donor or artificial cornea), the size and depth of the defect. Keratoplasty can be total or partial. In the first case, the entire cornea is replaced. In the second - parts of the organ, the size of the graft is from 4 to 6 mm. In addition, subtotal retinoplasty is sometimes performed. It means the replacement of the cornea over almost the entire area, with the exception of a small rim (1-2 mm) located around the limbus. Depending on the depth of the lesion, end-to-end and layer-by-layertransplant. In the first case, the defect occupies the entire thickness of the organ. Layered retinoplasty can be anterior and posterior (the outer or inner wall of the cornea is affected). As a donor organ, cadaveric material is used, including from newborns. The artificial graft is made in special laboratories.
How to prepare for keratoplasty?
Eye microsurgery, like other types of surgical procedures, involves preparation before performing the intervention. First of all, it is necessary to carry out therapeutic treatment of inflammatory processes. This applies to any infections of the eye and eyelids (conjunctivitis, iridocyclitis). After treatment of the infection, a complete diagnosis of the organs of vision is carried out. An ophthalmological examination, laboratory tests (UAC, OAM, blood biochemistry) are performed. It is also necessary to find out what pathologies the patient has. This is very important, as some diseases may be contraindications for surgery. On the eve of retinoplasty, it is necessary to observe a “hungry regimen”.
Corneal transplant technique
Corneal transplantation is performed using special microsurgical equipment. To perform retinoplasty, both traditional surgery and a laser procedure are performed. In recent years, the second method is considered more preferable, as it reduces the postoperative period and reduces the risk of complications. Eye cornea transplantation has a specific technique. First, the patient is laid on the couch and anesthesia is performed. After that, the eyelids and the eye are fixed (beyond the edge of the sclera). The next stage is the removal of the damaged organ or part of it (performed by a laser or a surgical instrument). The next step is corneal transplantation. The final stage involves examining the seams, examining for complications.
Postoperative period for keratoplasty
After a corneal transplant, the patient must be under medical supervision for at least a few hours. Despite the fact that the patient is allowed to go home, he needs to be examined by an ophthalmologist. Also, after the operation, a sparing regimen for the eyes (minimum stress on the organ of vision) is recommended. With surgical correction, the sutures are removed after a few months (up to a year). Possible complications of keratoplasty are bleeding, inflammation, graft rejection. In these cases, discomfort, photophobia, itching, etc. appear. Any symptoms are a reason for an urgent appeal to an ophthalmologist.
Corneal transplant: expert reviews
According to doctors, retinoplasty is a safe and effective method of restoring vision. It is recommended to all patients who do not have contraindications. Patients are satisfied with the operation. Vision is preserved for many years after transplantation, and complications are very rare. At the moment, laser transplantation of the cornea of the eye is considered to be predominant. The cost of the operation depends on the choice of clinic. average priceis 50-70 thousand rubles per eye. When choosing an artificial graft, the cost is doubled.
