PK Pamphlet (Corneal Transplantation)
Cornea:
The cornea acts as a protective layer and a window that allows light rays to reach the retina. Its transparency is due to its uniform structure, lack of blood vessels, and absence of water content.
The cornea protects the internal structures of the eye and directs light rays into the eye.
Corneal Transplantation:
This procedure involves replacing a damaged cornea with a donated cornea.
Causes of Corneal Transplantation:
The main reasons for corneal transplantation include corneal rupture, corneal edema, corneal opacity, and keratoconus. In Iran, the most common reason for corneal transplantation is keratoconus.
Types of Corneal Transplantation:
- Penetrating Keratoplasty (PKP)
- Lamellar Keratoplasty (LKP)
- Full-thickness Corneal Transplantation (This is the last resort, and candidates for this procedure must undergo extensive examinations.)
Preoperative Evaluation:
- A comprehensive eye examination is necessary before transplantation, including an assessment of the patient’s social situation to determine if they can comply with post-operative care and seek medical attention promptly in case of complications.
- Simple clinical tests, such as color vision assessment.
- Dry eye syndrome and incomplete eyelid closure should be diagnosed and treated before transplantation.
- Anesthesia evaluation should be performed for elderly patients.
- Neurological or intraocular conditions that may affect visual outcomes, such as lens opacity, retinal hemorrhage, or glaucoma, should be assessed.
- Ocular inflammation should be completely resolved several months before corneal transplantation.
- Patients should be monitored for conditions such as diabetes and hypertension before undergoing surgery.
- Avoiding smoking positively affects the success and longevity of the transplant, so it is advisable to reduce or quit smoking.
Post-Operative Care & Instructions:
- Proper and regular use of medications, attending follow-up appointments, and protecting the eye from trauma are essential. (For this purpose, wear an eye shield for several weeks after surgery.)
- Avoid rubbing your eye, straining, lifting heavy objects, and engaging in strenuous physical activities. (Walking is allowed.)
- Perform prayers (Namaz) with gestures for a while and avoid bending your head forward.
- Maintain a 5 to 10-minute interval between eye drops.
- Eye makeup is permissible after one month.
- Be aware of signs of transplant rejection and seek immediate medical attention if they occur.
The Most Important Signs of Transplant Rejection:
- Light sensitivity
- Eye redness
- Foreign body sensation in the eye
Important Note:
Corticosteroid eye drops are the primary treatment for corneal allograft rejection. Therefore, it is crucial to use them correctly and on time. These include:
- Dexamethasone drops
- Betamethasone drops
- Prednisolone drops
Wishing you a speedy recovery!