Corneal transplantation is a surgical procedure used to repair corneal damage or disease by transplanting healthy corneal tissue to replace the affected area, thereby restoring vision or improving eye function. This surgery is primarily indicated for patients with corneal opacity, deformity, or functional abnormalities caused by trauma, disease, or congenital defects. The procedure can be classified into full-thickness (penetrating keratoplasty) and partial-thickness (lamellar keratoplasty) transplants, with the most suitable approach selected based on the patient's condition.
Corneal transplantation includes two main types: "penetrating keratoplasty" and "lamellar keratoplasty." Penetrating keratoplasty involves removing the entire corneal tissue and replacing it with a donor's full-thickness cornea, suitable for severe infections or full-thickness opacities. Lamellar keratoplasty replaces only the damaged layers, such as the epithelium or endothelium, preserving healthy tissue to reduce rejection risk.
The mechanism involves using healthy donor corneal tissue to restore transparency and shape. The transplanted tissue is secured with sutures and complemented by immunosuppressants to prevent rejection. The degree of visual recovery post-surgery depends on the extent of corneal damage, surgical technique, and patient recovery.
This procedure is suitable for conditions such as:
The surgery is typically performed under local anesthesia. The surgeon removes the damaged corneal tissue and sutures the donor tissue in place. Postoperatively, patients must use steroid eye drops and immunosuppressants daily for several weeks to years to reduce rejection risk. The dosage and frequency must strictly follow medical instructions and should not be adjusted independently.
Corneal transplantation effectively improves vision impaired by corneal diseases, with a success rate of 70% to 90%. Some patients can regain visual acuity above 0.5. Its advantages include:
Possible complications include:
Patients with the following conditions should be carefully evaluated:
Postoperative care is critical: Avoid eye rubbing, contact with contaminated environments, and regularly follow up to monitor rejection indicators. Patients with other eye conditions such as glaucoma must control these issues before surgery.
Postoperative use of corticosteroids may interact with systemic medications; for example, patients on long-term steroids may need dosage adjustments. Patients who have undergone corneal collagen cross-linking (CXL) should inform their doctor, as structural changes may affect transplant success.
Clinical statistics show that the 5-year survival rate for penetrating keratoplasty is approximately 75-85%, with lamellar keratoplasty having higher success rates in specific conditions. Recent advances such as Descemet membrane endothelial keratoplasty (DMEK) have reduced rejection rates to below 10%, demonstrating the impact of technological progress on outcomes.
For patients with mild corneal disease, alternatives include:
When choosing alternatives, the severity of the condition and the patient's overall health should be evaluated. Some cases may require combined treatments.
What preparations should be made before surgery to improve success rates?
Prior to corneal transplantation, detailed eye examinations are necessary, including corneal thickness, intraocular pressure, and overall health assessment. Patients should inform their doctor of any medications they are using, especially anticoagulants or immunosuppressants, as these may affect surgical safety. Additionally, avoid rubbing the eyes or wearing contact lenses before surgery to reduce infection risk.
What are the potential risks of using steroid eye drops postoperatively, and how should they be used correctly?
Long-term use of steroid eye drops may increase intraocular pressure or cause cataracts, but moderate use effectively suppresses rejection. Doctors will adjust the dosage based on recovery progress. Patients must strictly follow the prescribed schedule and avoid stopping or prolonging use independently. If symptoms like increased eye pressure or blurred vision occur, seek medical attention immediately.
What activities should be avoided in daily life after surgery to protect the transplanted cornea?
Within three months post-surgery, avoid contact with contaminated environments, swimming, or activities that may impact the eye (such as boxing or ball sports). Use waterproof eye shields when bathing to protect the wound, and avoid getting shampoo or cosmetics into the eyes. Bending over or heavy lifting should be minimized to reduce intraocular pressure.
What are the signs of corneal rejection, and how should they be managed if they occur?
Signs include sudden blurred vision, eye redness, swelling, pain, or light sensitivity, most commonly within the first six months post-surgery. If these symptoms appear, patients should return to the hospital immediately for examination. The doctor may adjust immunosuppressive medication or initiate anti-rejection treatment. Early detection significantly improves control success, so daily self-monitoring and regular follow-ups are essential.
How long does it take for vision to fully recover after corneal transplantation, and what are the main factors affecting the outcome?
Recovery time varies; minor injuries may improve in 1-3 months, while severe scars or deformities may take 6-12 months. Key factors influencing outcomes include the extent of corneal disease, adherence to medication instructions, and successful rejection prevention. Good blood sugar control and avoiding secondhand smoke environments can also reduce complications.
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