Name of the Procedure:

Keratoplasty (corneal transplant); penetrating (in aphakia)

Summary

A corneal transplant, also known as keratoplasty, is a surgical procedure to replace a damaged or diseased cornea with a healthy donor cornea. Penetrating keratoplasty involves transplanting all layers of the cornea. This specific procedure, performed in aphakia, applies to patients without a natural lens in the eye.

Purpose

Keratoplasty addresses various corneal conditions that impair vision. The primary goals are to restore clear vision, relieve pain from corneal disease, and improve the appearance of the cornea.

Indications

• Severe corneal scarring or thinning
• Advanced keratoconus
• Corneal edema or opacification
• Corneal dystrophies
• Previous corneal transplant failure
• No natural lens in the eye (aphakia)

Preparation

• Fasting may be required for 8-12 hours prior to surgery.
• Adjustments to current medications as advised by the doctor.
• Comprehensive eye examination including measurements of the cornea and detailed health history.
• Arrange for post-surgery transportation.

Procedure Description

1. The patient is given local or general anesthesia.
2. The eye is cleaned and covered with a sterile drape.
3. The surgeon removes the damaged corneal tissue using a trephine.
4. A matching donor cornea is prepared and sutured into place.
5. The surgeon checks for proper fit and seals the graft.
6. Antibiotic drops are applied, and the eye is bandaged.

Duration

Typically, the procedure takes about 1-2 hours.

Setting

Performed in a hospital, outpatient clinic, or surgical center with specialized ophthalmic surgical facilities.

Personnel

• Ophthalmic surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Infection
• Rejection of the donor cornea
• Increased intraocular pressure
• Detachment of the retina
• Complications from anesthesia
• Recurrence of the original corneal disease

Benefits

• Restoration of clear vision
• Relief from pain caused by corneal conditions
• Improved cosmetic appearance of the cornea

Recovery

• Use prescribed eye drops to prevent infection and reduce inflammation.
• Wear an eye shield as advised.
• Avoid heavy lifting and strenuous activities for several weeks.
• Regular follow-up appointments to monitor healing.
• Complete recovery can take several months to a year.

Alternatives

• Phototherapeutic keratectomy (PTK)
• Corneal collagen cross-linking (CXL)
• Contact lenses or glasses for mild conditions
• Conservative management based on the patient's specific condition

Patient Experience

Patients may feel some discomfort and experience blurry vision immediately after the procedure. Pain is typically managed with prescribed medications. Vision gradually improves over several months, and most patients experience a significant visual improvement and comfort as healing progresses.