Cornea transplant surgery involves surgically removing the patient’s partially or entirely damaged cornea and replacing it with a healthy donor cornea. The cornea is a transparent structure that plays a vital role in vision and light perception. Situated in front of the pupil, iris, and anterior chamber, the cornea’s function is to focus the refracted rays into the lens and subsequently retina for vision facilitation.
At times, factors like infections, degeneration, or other conditions result in decreased transparency or infectious state of the cornea. This results in vision loss accompanied by symptomatic issues like severe pain, redness, and inflammation with other issues. This impairs your daily life activities and overall quality of life through impaired vision. Corneal transplant surgery is recommended when other treatment options fail or do not produce satisfactory vision recovery or symptomatic relief.
Cornea Transplant in London
The technological and infrastructural superiority of the UK over other nations worldwide has resulted in many developments in London’s healthcare economy. Most importantly, it has resulted in an influx of medical tourism and subsequent skilled medical practitioners. Cornea transplant in London is considered one the best among western countries. The most important reasons for this development being
– Superior surgical technology
– Awareness among people about eye donation
– Experienced and skilled medical practitioners
Superior Surgical Technology
Before understanding the technology, it is first essential to know about the structure of the cornea. The cornea, apart from being a transparent avascular structure, is divided into five layers:
- Epithelium-absorbs nutrients and tears from the tear film and conveys it to the rest of the cornea.
- Bowman’s membrane- works as a physical barrier to protect the sub epithelial nerve plexus and help in sensory recovery
- Bowman’s membrane- works as a physical barrier to protect the sub epithelial nerve plexus and help in sensory recovery
- Descemet’s membrane -anchors endothelium to the cornea while allowing entry of nutrients and micro molecules into the stroma
- Endothelium- helps maintain clarity of cornea with its dehydrated state.
In short, impact to the epithelium and Bowman’s membrane can be repaired and the cornea regenerated with superficial scarring. But more profound impacts than that lead to severe scarring, vision loss, and compromise to the structure of the cornea.
Since its advent in 1903, the corneal transplant has come a long way from replacing a full-thickness cornea with all its layers to the corneal replacement of only the infected layers. Keeping in pace with the surgical advancements, cornea transplant in London is performed through EK or Endothelial Keratoplasty methods. Considered a superior approach to traditional procedures, EK cornea transplant in London involves the techniques of:
A. PALK (Pachymetry Assisted Lamellar Keratoplasty)
This is useful in fragile corneal conditions like advanced keratoconus. Conditions of corneal ectasia after LASIK procedure and corneal cases with anterior stromal opacities respond well to the PALK transplant method.
B. DALK (Deep Anterior Lamellar Keratoplasty)
It is recommended for cases of keratoconus and corneal scars. In this method, a corneal transplant is conducted of the first three layers while the person’s Descemet’s Membrane and endothelium are left intact.
C. DSEK (Descemet’s Stripping Endothelial Keratoplasty)
In this method, only the Descemet’s Membrane and Endothelium of cornea are removed and replaced with donor Descemet’s Membrane and endothelium. DSEK is indicated for cases of surgically acquired corneal damage (bullous keratopathy) or to replace a failed previous graft of corneal transplant.
D. DMEK (Descemet’s Membrane Endothelial Keratoplasty)
In this case, the stroma is replaced with the Descemet’s Membrane and Endothelium while keeping the epithelium and Bowman’s membrane intact. DMEK is indicated in cases of hereditary or acquired Endothelial dystrophy or for managing cases of failed Endothelial transplant.
These methods require great precision and skills for a good outcome. None of these methods have a 100 % success rate. The risk of graft rejection though less than in cases of penetrating Keratoplasty is still evident.
Eminent ophthalmology centers, like Harley Vision, practice Cornea transplants in London using superior surgical techniques. The specialized medical infrastructure and advanced eye bank technology considerably improve the success rate of surgery by providing an excellent visual prognosis afterward.
Awareness Among People Regarding Aye Donation
A transplant is virtually impossible without a donor cornea. The United Kingdom has witnessed an increased graph of eye donors in the last decade. Increased awareness among the citizens regarding corneal donation is an important reason behind the success of Corneal Transplant in London. Several conditions make it essential to opt for a corneal transplant. Some of these conditions are:
● Extensive and irreversible corneal damage due to scarring of internal layers (Traumatic or congenital)
● Pseudophakic or Aphakic Bullous keratopathy- Surgical induced corneal inflammation and damage during cataract surgery.
● Severe Keratoconus conditions- A condition of extensive corneal scarring due to the irregular conical shape of the cornea
● Previous failed corneal transplant surgery.
In all of these cases, a suitable donor cornea is as essential for the success of surgery as other surgical factors. Donor corneas are obtained from eye banks that play a crucial role in recovering, preparing, and delivering donated eyes for corneal transplant surgery. Public awareness regarding eye donation has increased donor corneas and, subsequently frequency of cornea transplant cases in London.
The innovative and holistic approach of doctors like Dr. Mukhtar Bizrah has provided visual, symptomatic, and psychological relief to numerous visually impaired patients opting for cornea replacement in London.
Experienced And Skilled Medical Practitioners
Apart from availability, several aspects of donor cornea can impact the success of a cornea replacement surgery. Foremost is the quality of donor graft. Depending on the donor they are procured from, corneas are graded from average to excellent depending on corneal condition. Second comes the surgical techniques. Corneal transplants require surgical precision for transplant procedure. Fine incisions are necessary to avoid damaging the layers to be transplanted.
The surgeon’s skills become crucial at this moment to ensure an effective corneal transplant, keeping in mind the above factors. The surgeons’ skills with a vast experience of handling transplantation cases have resulted in the success and increasing demand for cornea replacement in London. Dr. Mukhtar Bizrah has performed hundreds of successful transplant surgeries to date. He is known for his minimally invasive keyhole transplant surgery that maximizes visual outcome and considerably reduces the risk of rejection.
The success of a corneal transplant surgery ranges from 65-90%. Proper pre-operative and post-operative care is vital for the success of the corneal transplant. Eminent cornea replacement centers in London and other places provide a care guidelines booklet. This makes it easier for the patient to be educated and aware of their condition.
Many visually impaired patients who can benefit from a cornea transplant surgery are prevented from doing so because of the increased cost of a cornea transplant and its somewhat uncertain outcome. Apart from the increased success rate of corneal transplants, Dr. Mukhtar Bizrah provides his services to needy people undergoing cornea replacement in London at affordable costs.
Cornea Transplant Cost In London
In London, cornea transplant cost is not the same at all centers but varies in different medical centers. Cornea transplant cost in London depends on
– Type of Cornea transplant
– Cost related to donor graft
– Your insurance policies and healthcare plans
Apart from these, the services of your surgeon, medical team, and hospital costs directly influence the cost of cornea replacement in London. Some surgeons actively practice cornea replacement in London paired with other ocular procedures like cataract surgeries. This impacts the overall cornea transplant cost in London.
The clinic’s location is another critical factor impacting the cornea transplant cost in London. Clinics at the heart of the city are easily accessible by transport facilities. They are also near accommodation facilities and eateries that make it convenient for the person’s attendant. An easy-to-accessible location makes it suitable for the patient to attend regular follow-up sessions after cornea replacement in London.
Not All Can Donate Or Receive A Cornea.
Despite the success of Cornea replacement in London and increasing awareness about it, some important factors need to be understood. Not all are eligible to undergo surgery or donate their eyes for cornea replacement.
You cannot get a corneal transplant if you have non-corneal reasons for vision impairment, like glaucoma-induced optic atrophy or retinal impairment. The risks of graft rejection after surgery if the scarring is due to infectious conditions that are viral or fungal. Additionally, severely damaged conical corneas or graft rejection have a better prognosis.
Most importantly, corneal impairment due to chemical burns cannot be treated by corneal transplant. In this condition, corneal replacement is performed through Keratoprosthesis, an advanced method of corneal transplant performed by very limited surgeons.
Like in corneal transplants, there exists donor graft selection criteria. For DMEK cornea transplant, donor age must be between 50-75 years. Donor age can be between 2-75 years. Additionally, people who have had refractive surgeries other than cataract surgery are not eligible donors.
Donor awareness and patient education about cornea transplants are as crucial as the surgeon’s skills for a successful cornea replacement. Only a harmonious balance between the two can ensure a successful cornea transplant or cornea replacement operation.
