CORNEA SURGERY
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CORNEA TRANSPLANT
Corneal transplant, also known as keratoplasty or corneal tissue transplant, is a surgical procedure in which a portion, or the entire damaged, or diseased cornea of a patient is replaced with a healthy cornea from a donor.
The cornea is the transparent, convex part of the eye that covers the pupil and iris, helping to focus light on the eye.
Here is an overview of the procedure:
1. Patient Assessment:
- The patient undergoes a thorough evaluation to determine the need for a cornea transplant and his suitability for the procedure.
2. Donor Preparation:
- The cornea to be transplanted is taken from a deceased donor, usually through organ donation programs. There are excellent Eye Banks scattered throughout the national territory which guarantee the removal of corneas.
3. Surgery:
- The transplant patient is anesthetized.
- The surgeon removes the damaged or diseased cornea.
- The donated cornea is then sewn or taped in place of the removed cornea.
4. Fixing and Healing:
- The transplanted corneal tissue is fixed and the patient begins the healing process.
- After the procedure, medications may be needed to prevent rejection of the transplanted tissue.
Corneal transplant is performed to restore visual clarity and treat conditions such as keratitis, keratoconus, corneal scarring, and other serious corneal diseases. The success of the procedure depends on the patient's specific condition, the body's immune response to the transplanted tissue, and compliance with post-operative instructions.
CORNEAL ENDOTHELIUM TRANSPLANTATION
DSAEK (Descemet's Stripping Automated Endothelial Keratoplasty) corneal endothelial transplant is an advanced surgical procedure used to treat corneal diseases involving the endothelial layer (the innermost part of the cornea), such as corneal edema due to endothelial cell dysfunction .
Here's how the procedure works:
1. Donor Preparation:
- A thin layer of corneal tissue containing the endothelial layer is taken from a deceased donor. There are excellent Eye Banks scattered throughout the national territory which guarantee the removal of corneas.
2. Removal of Defective Endothelial Layer:
- The surgeon removes the damaged or diseased endothelial layer from the patient's cornea.
3. Insertion of the Donated Lamella:
- The donated lamella containing the endothelial layer is inserted and positioned on the patient's cornea.
4. Air or Gas to Adapt the Reed:
- Air or a gas is inserted into the front chamber of the eye to fit the blade into place.
5. Healing and Recovery:
- The patient undergoes a healing period while the donated lamella integrates with the recipient's cornea.
This procedure is less invasive than traditional penetrating keratoplasty (PK), in which the entire thickness of the cornea is transplanted.
The DSAEK technique is specifically aimed at replacing only the endothelial layer, reducing the risk of complications associated with more invasive surgery.
DSAEK Corneal Endothelial Transplantation is often used to treat Fuchs* endothelial dystrophy and chronic corneal edema due to endothelial dysfunction, helping to improve endothelial cell function and restore visual clarity.
*Fuchs endothelial dystrophy
Fuchs corneal dystrophy is a progressive eye disease that affects the endothelial layer of the cornea, the back, innermost part of the eye.
This layer is composed of endothelial cells responsible for maintaining the correct balance of fluids in the cornea, helping to keep it transparent.
Main features of Fuchs corneal dystrophy:
1. Accumulation of Extracellular Material:
- The disease manifests itself with the accumulation of deposits of extracellular material called guttata droplets (from the Latin “gutta” = drop) on endothelial cells.
2. Gradual Loss of Endothelial Cells:
- Over time, a gradual loss of endothelial cells occurs, reducing the ability to regulate the water content in the cornea.
3. Corneal Edema:
- Lack of control over fluid balance leads to corneal edema (swelling), causing blurred vision, clouding of the cornea and sensitivity to light.
4. Visual disturbances:
- Fuchs corneal dystrophy can cause visual disturbances, especially in the morning when the edema is more pronounced.
Symptoms may progress over time, and in some cases, corneal transplant may be necessary.
When symptoms significantly interfere with vision and quality of life, surgery, such as DSAEK corneal endothelium transplant or other corneal surgery options, may be considered.
Regular evaluation by an ophthalmology specialist is important to monitor and manage Fuchs corneal dystrophy.
CROSS LINKING FOR KERATOCONUS
Corneal cross-linking para surgery is a procedure used to treat keratoconus, a corneal condition in which the cornea takes on a conical shape rather than maintaining its normal spherical shape.
This deformity can lead to gradual vision loss.
Here's how the corneal cross-linking procedure takes place:
1. Preparation:
- The patient receives local anesthesia in the form of eye drops.
2. Removal of corneal epithelium:
- In some cases, the corneal epithelium (the outermost layer of the cornea) is removed to allow better penetration of riboflavin, a vitamin B2 compound used in the cross-linking process.
3. Application of Riboflavin:
- Riboflavin is applied to the corneal surface and absorbed by the cornea.
4. Irradiation with ultraviolet light (UVA):
- After the application of riboflavin, the cornea is exposed to ultraviolet (UVA) light for a specific period of time.
- The combination of riboflavin and UVA activates the cross-linking process, strengthening the collagen fibers in the cornea.
The main goal of corneal cross-linking is to stabilize the cornea and slow or stop the progression of keratoconus.
This procedure may be particularly useful in young patients with early-stage keratoconus.
Corneal cross-linking para surgery is a well-established option and can help improve the stability of the cornea over time.
The ophthalmologist's evaluation will determine whether this procedure is appropriate for the patient's specific situation.
EYE CARE CLINIC
CRYSTAL PALACE third floor
Via Cefalonia, 70
24124 - Brescia
Telephone 0302428343
STUDIO DIECIDECIMI
Via Cesare Vivante, 1
95123 - Catania
Telephone 3516449431
