Types of Corneal Transplants:

  • Penetrating Keratoplasty (PKP): In PKP, the entire central portion of the diseased cornea is removed and replaced with a full-thickness donor cornea. Sutures are used to secure the donor tissue.

  • Deep Anterior Lamellar Keratoplasty (DALK): DALK involves removing and replacing only the diseased or abnormal front layers of the cornea, leaving the healthy endothelial layer intact. This technique is used when the innermost layer of the cornea (endothelium) is healthy.

  • Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) and Descemet's Membrane Endothelial Keratoplasty (DMEK): These are partial-thickness transplant techniques that replace only the innermost layers of the cornea (endothelium and Descemet's membrane). They are primarily used to treat endothelial dysfunction, such as in Fuchs' dystrophy or after corneal transplants.

  • Procedure: During a corneal transplant:

    • The surgeon removes the damaged corneal tissue and prepares the recipient bed.

    • Donor corneal tissue of the appropriate size and shape is placed and secured in position with sutures or occasionally with an adhesive.

    • Post-operative care involves regular follow-up visits to monitor healing and assess vision improvement.

  • Recovery and Outcome: Recovery time varies depending on the type of transplant performed and the individual patient's healing process. Patients may experience temporary blurred vision, discomfort, and sensitivity to light after surgery. Visual improvement can take several months as the eye adjusts to the new corneal tissue.

    Types of Anaesthesia:

    IV Sedation: For more complex or lengthy retina surgeries, IV sedation may be used in addition to local anesthesia. Conscious sedation involves administering medications through an IV line to induce a state of deep relaxation and drowsiness. While conscious, patients are generally able to respond to verbal cues and maintain their own airway, but they may not remember much of the procedure afterward.

    Peribulbar Block: This involves injecting local anesthetic into the tissue around the eyeball but outside the muscles that move the eye. It provides effective anesthesia for most types of retina surgeries.

    General Anesthesia:

    In some cases, especially when the patient may have difficulty remaining still or if additional procedures are planned alongside the corneal transplant, general anesthesia may be considered. General anesthesia renders the patient unconscious and unaware during the surgery.