What is a Corneal Transplant?

    Corneal transplant surgery or corneal graft procedure is done to replace a diseased or damaged cornea with healthy donor cornea tissue. It is helpful for people with progressive corneal disease like Fuchs dystrophy or keratoconus, along with cornea damaged by severe scarring due to injury or infections like keratitis. Cornea transplants are also helpful following eye surgeries which have resulted in damaged corneas.

     Corneal transplant surgery can involve removing either the entire thickness of the cornea, known as Penetrating Keratoplasty, or partial thickness of the cornea in in Lamellar Keratoplasty. Feel free to ask your doc for a corneal transplant surgery clinic in London, UK, for more information. Mr Mukhtar Bizrah specialises in minimally invasive keyhole cornea transplant surgery that maximises visual outcome and minimises risk of complications.

    Deep Anterior Lamellar Keratoplasty (DALK)

    DALK or Deep Anterior Lamellar Keratoplasty is a type of partial thickness corneal transplant surgery. Instead of removing the entire layer of the cornea, partial removal of the cornea until the Descemet’s membrane is done. The endothelium is left intact.

    DALK was initiated to decrease the risks associated with the complete removal of the cornea, such as cornea graft rejection. DALK is performed in corneal diseases affecting the front part of the cornea, such as keratoconus or cornea scarring.

    Endothelial Keratoplasty (E.K.)

    Endothelial Keratoplasty is a corneal transplant surgery useful in cases where the innermost corneal cell layer is affected.

    There are two types of endothelial keratoplasty, DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) in which the donor cornea is implanted with the Descemet’s Membrane, Endothelium, and a thin layer of stroma.

    DMEK (Descemet Membrane Endothelial Keratoplasty) is a corneal transplant surgery in which the donor cornea is implanted along with its Descemet’s Membrane and Endothelium but without the stroma.

    Visual recovery is much improved and faster in the case of DMEK, along with the decreased risk of complications. Our cornea clinic in London, UK, is a specialist clinic for DMEK surgery.

    Endothelial keratoplasty is the preferred type of surgery for progressive endothelial disorders like Bullous Keratopathy, ICE (Irido corneal endothelial syndrome), and Fuchs Dystrophy.

    Corneal Transplant Procedure

    First, the patient is assessed for suitability to have the surgery. The cornea transplant surgery can be done under local anaesthesia, sedation or general anaesthesia. The surgery itself should be painless. After prepping the eye, a speculum is inserted between the lids to keep them open during the procedure. The diseases cornea is removed, and replaced with healthy donor cornea tissue. 

    This can take 15 minutes to 1 hour, depending on the type of cornea transplant surgery. After the surgery, steroids and antibiotics are injected into the eye and are patched properly. Finally, a shield is plastered over the patch for extra protection. The patient is then followed up in clinic periodically to assess the post-operative progress. Vision can improve dramatically in a few days, or can take longer to recover in certain types of cornea transplants.

    What are the Benefits of Cornea Transplant Surgery?

     

    1. They can significantly improve the vision of the patient.
    2. They help in reducing pain associated with diseased corneas
    3. They improve the aesthetic appearance of a scarred or damaged cornea.

    Mukhtar Bizrah has travelled around the world to learn the best techniques in cornea transplantation. In his NHS and private practice, Mukhtar Bizrah offers all types of partial and full thickness cornea transplant surgeries. The most common are:

    1. Descemet membrane endothelial keratoplasty (DMEK)
    2. Descemet stripping automated endothelial keratoplasty (DSAEK)
    3. Deep anterior lamellar keratoplasty (DALK)
    4. Penetrating keratoplasty (PK)

    Conditions commonly treated with cornea transplants:

    1. Fuchs endothelial dystrophy
    2. Pseudophakic bullous keratopathy (cornea swelling due to previous eye surgery)
    3. Keratoconus
    4. Cornea scarring (e.g. due to previous infection)

    Frequent asked questions (FAQs):

    Vision improvement is the most common reason to perform a cornea transplant. The improvement in vision can be life-transforming, particularly with the latest techniques of cornea transplantation.

    Cornea transplantation is performed with anaesthesia, meaning the surgery itself very rarely results in pain. Major advances in cornea transplantation have resulted in significantly less pain after the surgery, and many patients experience very little or no pain.

    At the Harley Vision, cornea transplantation can be offered under local anaesthesia, sedation or general anaesthesia.

    Many surgeons only perform certain types of cornea transplants under general anaesthesia (GA). Mukhtar Bizrah is a strong advocate for use of local anaesthesia to perform cornea transplant surgery. This is to avoid the risks of GA, particularly in patients with other medical conditions.

    The recovery time from a cornea transplant can range from days to months, and is very much dependent on the type of cornea transplant that is needed. This will be explained to you by the surgeon during your clinical consultation.

    Corneal transplant surgery can help in restoring vision in various corneal diseases, leading to a remarkable improvement in vision. Just look for the best corneal transplant surgery clinic in the UK, London, to be under the care of a highly experienced corneal surgeon.

    With corneal transplantation, the scarred or affected portion of the eye is removed surgically and a healthy donor cornea is replaced in its place.

    The patient can get better vision, a better cosmetic effect, and even relief from pain with corneal transplantation. However, it is best to ask your corneal surgeon in London, UK, about the why the surgery is required and what type.

    During the corneal transplant surgery, you can expect the surgeon to anesthetise your eye either by local or general anesthesia. The surgery can be performed with or without insertion of stitches, and is becoming more minimally invasive. This whole process of corneal transplant surgery may seem a hassle, but with an ideal specialist clinic in London and experienced surgeon by your side, the process is less daunting than anticipated.

    This is one of the most common questions asked by patients attending our cornea transplant surgery clinic in London. Vision can improved remarkably in a couple of days, and will take significantly longer for more complex cornea transplants, such as full thickess cornea transplants. The surgeon in our corneal transplant surgery clinic in London will advise you regarding the Do’s and Don’ts following surgery, and how to maximise the chance of speedy visual recovery.

    There are various conditions affecting different layers of the cornea which may necessitate cornea transplant surgery. For example, cornea transplantation may be required for any degenerative conditions like Fuchs dystrophy and ICE (Iridocorneal Endothelial Dystrophy). You may also need to look for a clinic in London, UK, for corneal transplant surgery if you have structural conditions like Keratoconus or extremely thin and scarred corneas.

    Some patients are also advised for corneal transplant surgery following inflammatory conditions like ulcerative keratitis. Furthermore, traumatic conditions like accident-induced scars and severe chemical and thermal burns may also require corneal transplant surgery. The surgeon may also advise you for cornea transplantation following unsuccessful refractive surgery.

    Our cornea clinic in London, UK, specializes in treatment of complex cornea diseases, and reviewing cornea cases for second opinions.

    Here are some common forms of corneal transplant surgery that are performed by Mr Mukhtar Bizrah at our cornea clinic in London, UK:

    1. Endothelial Keratoplasty (E.K.) – partial thickness corneal transplant surgery.
    2. DSEK (Descemet’s Stripping Endothelial Keratoplasty)- donor tissue replaces 1/3rd of the cornea.
    3. DMEK (Descemet’s Membrane Endothelial Keratoplasty)- uses a thinner tissue than DSEK type corneal transplant surgery.
    4. ALK (Anterior Lamellar Keratoplasty)-Removes the front layer of the cornea and leaves the posterior layers intact, unlike other corneal transplant surgery.
    5. DALK (Deep Anterior Lamellar Keratoplasty)- When most of the cornea layers are removed, leaving behing a think back layer.
    6. SALK (Superficial Anterior Lamellar Keratoplasty) – In this type of corneal transplant surgery, only some of the front layer of the cornea is removed, preserving stroma, Descemet’s Membrane and endothelium.
    7. Penetrating Keratoplasty (P.K.) -full-thickness corneal transplant surgery.

    Our cornea clinic in London also specializes in performing partial thickness corneal transplants behind failed full thickness transplants. This is a less invasive procedure that can result in remarkable visual recovery.

    Nowadays, with modern eye banking and advanced surgery methods, out success rate for corneal transplant surgery in London, UK is higher than ever. The success rate depends on the type of cornea transplant, the risk factors, follow up and compliance with treatment (e.g. eye drops) following surgery.

    A corneal transplant surgery can take between 20 minutes and one hour. It can take up to 1.5 hours in complex cases. The before and after surgery process also takes time.

    After cornea transplantation, follow up with your surgeon is extremely important.

    Cornea transplant surgery is performed under local anaesthesia, sedation or general anaesthesia. The operation itself should be painless. There can be discomfort after the transplantation, depending on the type performed.

    Although the corneal transplant surgery in London, UK, is done using advanced technology by a highly skilled surgeon, there are some potential risks associated with surgery. These risks include cornea graft rejection, graft detachment, infection, glaucoma, cataract formation, etc. Risks of cornea graft rejection vary with the type of cornea transplant performed and the indication for surgery, and will be discussed in more detail by your cornea transplant surgeon.