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Full-thickness cornea transplant, penetrating keratoplasty - A State of Sight #12

Isaac Porter, MD explains penetrating keratoplasty, a full-thickness corneal transplant, which may be needed for patients with swollen, cloudy corneas, keratoconus, or inherited diseases. Corneal transplantation is one of the most successful types of transplantation in humans.




Welcome to A State of Sight, I’m Isaac Porter from Lowry Porter Ophthalmology and we continue to bring you the latest in ophthalmology and eye care right here from Raleigh, NC. In this episode, I would like to explain the details about corneal transplantation when we use a full thickness corneal transplant, which is also called penetrating keratoplasty.
 
This is when we remove the entire central part of the cornea from the patient’s eye and then replace it with a new, clear cornea from a donor. The donors are carefully screened for infectious diseases and any problems that may cause trouble with the transplant.
 
After the donor corneas are harvested, they are preserved in preparation for transplantation. There is a sufficient supply of donors, so that we can schedule a corneal transplant whenever we wish without having a waiting list or having patients waiting for a donor to become available.
 
This type of corneal transplantation is usually performed on patients that have a cloudy or swollen cornea that is no longer clear. Once we replace the old cornea, the patient can then have a clear cornea to improve their vision.
 
Most of the time, this is caused by swelling, scarring, keratoconus, or from Fuchs dystrophy which, as we covered before, can be treated with an inner layer corneal transplant or DSEK. Other reasons for a full thickness corneal transplant could be failure of a previous transplant, a scar or an ulcer in the clear area, or if patients have a viral disease that caused cloudiness of the cornea.
 
Afterwards, patients need to use antibiotic drops for a short period of time and then steroid drops for an extended period. These steroids help prevent rejection of the cornea.
 
Corneal transplants are one of the most successful transplants throughout the human body and depending on the reason the surgery was performed, usually about 80% of the transplants survive after 5 years.
 
In the cases where the transplant is rejected, steroid drops or pills can help decrease the episode of rejection and help the transplant survive. In other cases where there’s no rejection, the corneas can fail, become cloudy, and may require repeat transplantation.
 
Thanks again for joining us on A State of Sight, and as always, if you have any questions or comments about corneal transplantation please post them and we’ll be happy to interact with you. Until next time, good health and good sight.