{"id":4893,"date":"2020-05-30T10:12:57","date_gmt":"2020-05-30T05:42:57","guid":{"rendered":"https:\/\/drsiamakzarei.com\/%d9%be%db%8c%d9%88%d9%86%d8%af-%d9%82%d8%b1%d9%86%db%8c%d9%87-%d9%88-%da%a9%d8%b1%d8%a7%d8%aa%d9%88%d9%be%d9%84%d8%a7%d8%b3%db%8c\/"},"modified":"2026-08-27T16:58:46","modified_gmt":"2026-08-27T13:28:46","slug":"corneal-transplantation","status":"publish","type":"post","link":"https:\/\/drsiamakzarei.com\/en\/corneal-transplantation\/","title":{"rendered":"Corneal Transplantation & Keratoplasty"},"content":{"rendered":"

What is Corneal Transplantation and How is it Performed?<\/b><\/h1>\n

Corneal transplantation is a surgical procedure in which a patient’s damaged or diseased cornea is replaced with healthy donor corneal tissue. There are two primary types of transplantation: if the full thickness of the cornea requires replacement, the procedure is termed Penetrating Keratoplasty (PKP); if only specific diseased layers are replaced, it is called Lamellar Keratoplasty. Donor corneal tissue is procured from accredited eye banks. Neglecting damaged corneal tissue causes significant visual distortion, light scattering, severe blurring, and disabling glare.<\/p>\n

Corneal diseases represent the fourth leading cause of global blindness (following cataracts, glaucoma, and age-related macular degeneration), affecting over ten million individuals worldwide. Since 1961, more than one million patients annually have regained functional vision through corneal transplantation.<\/p>\n

When is Corneal Transplantation Indicated?<\/b><\/h2>\n

A transparent, structurally sound cornea is essential for clear vision. Corneal trauma or pathology leads to structural distortion, ocular pain, visual impairment, and inflammation.<\/p>\n

Note:<\/i> Corneal transplantation may also be required in conditions such as trichiasis, where inward-turned eyelashes chronically abrade the globe, causing non-healing ulcers and eventual blindness.<\/p>\n

Surgery is indicated when medical therapy, eyeglasses, and specialty contact lenses can no longer restore functional vision or control painful inflammation. Key conditions threatening corneal transparency include:<\/p>\n

    \n
  • Infectious corneal scarring (e.g., herpes simplex keratitis, fungal keratitis)<\/li>\n
  • Ulceration secondary to severe trichiasis<\/li>\n
  • Inherited endothelial dystrophies (e.g., Fuchs’ endothelial dystrophy)<\/li>\n
  • Advanced, ectatic keratoconus<\/li>\n
  • Extreme corneal thinning and irregular astigmatism<\/li>\n
  • Rare, severe complications following previous refractive laser procedures<\/li>\n
  • Chemical burns and severe mechanical ocular trauma<\/li>\n
  • Chronic, irreversible corneal edema (bullous keratopathy)<\/li>\n
  • Graft failure or rejection following prior keratoplasty<\/li>\n
  • Corneal endothelial decompensation following complex cataract surgery<\/li>\n<\/ul>\n

    Candidacy Evaluation<\/b><\/h3>\n

    Patients suffering from vision loss or persistent ocular pain due to corneal disease are evaluated for transplantation.<\/p>\n

      \n
    • Surgical Duration:<\/b> 1 to 2 hours<\/li>\n
    • Visual Outcome:<\/b> Significant restoration of functional vision<\/li>\n
    • Recovery Period:<\/b> Several weeks up to one full year<\/li>\n<\/ul>\n

      Key Pre-Operative Questions:<\/b><\/p>\n

        \n
      • Does your visual impairment interfere with occupational duties, mobility, and daily tasks?<\/li>\n
      • Have conservative, non-surgical modalities (such as rigid gas permeable or scleral lenses) failed to provide adequate vision?<\/li>\n
      • Have you evaluated the financial and health insurance coverage across the entire pre- and post-operative continuum?<\/li>\n
      • Are you able to accommodate extended recovery timelines and follow-up schedules lasting 6 to 12 months?<\/li>\n<\/ul>\n

        Perioperative Protocol<\/b><\/h2>\n

        Pre-Operative Care:<\/b><\/h3>\n

        Once scheduled, the patient is registered on the eye bank donor waitlist (typical waiting times range from several days to a few weeks). All donor tissues undergo mandatory serological and microbiological screening (including HIV, Hepatitis B and C) to guarantee recipient safety.<\/p>\n

        Intraoperative Procedure:<\/b><\/h3>\n

        Surgery is performed under general or monitored local anesthesia with retrobulbar\/peribulbar blocks based on patient age, systemic health, and surgical complexity.<\/p>\n

          \n
        • Penetrating Keratoplasty (PKP):<\/b> The full-thickness diseased corneal button is trephinated and excised using precision trephines or femtosecond lasers. A matching donor button is positioned and secured with micro-sutures (10-0 nylon), remaining in place for a year or longer. The outpatient procedure lasts 1 to 2 hours, after which the patient is discharged with a protective shield.<\/li>\n
        • Endothelial Keratoplasty (DSEK \/ DMEK):<\/b> Selective replacement of the dysfunctional inner endothelial layer and Descemet’s membrane while preserving the healthy anterior host stroma. The micro-thin donor tissue is introduced through a small self-sealing incision and secured against the host bed using an intraocular air\/gas bubble, eliminating corneal surface sutures. As endorsed by the American Academy of Ophthalmology, endothelial keratoplasty delivers faster visual rehabilitation, superior optical stability, minimal induced astigmatism, and reduced surgical morbidity compared to full-thickness PKP.<\/li>\n<\/ul>\n

          Donor Tissue Criteria:<\/b><\/h3>\n

          While historical criteria excluded donors over 65, multi-center longitudinal studies confirm that corneas from donors aged 34 to 71 maintain excellent endothelial health and graft clarity, with 10-year survival rates exceeding 75%. Tissues from younger donors (under 34) are preferentially allocated to younger recipients.<\/p>\n

          Post-Operative Recovery:<\/b><\/h3>\n

          Full tissue healing requires 12 months or longer. Vision is initially blurry and fluctuates over the early months. Heavy lifting, straining, and vigorous exercise are strictly prohibited during the initial postoperative weeks. Topical corticosteroid drops are prescribed for extended months to prevent immune rejection, alongside broad-spectrum prophylactic antibiotic coverage. Protective eye shields must be worn during sleep. Suture adjustment and selective suture removal occur between 3 and 18 months based on topographic astigmatism and wound healing.<\/p>\n

          Corneal Graft Rejection:<\/b><\/h3>\n

          Corneal transplantation is one of the most successful organ transplant procedures worldwide. When detected promptly, up to 90% of rejection episodes (9 out of 10) are successfully reversed with intensive topical corticosteroids. Graft rejection occurs in 5% to 30% of cases when the host immune system recognizes foreign donor antigens. Pre-existing glaucoma, active ocular inflammation, and previous graft failures increase rejection risks.<\/p>\n

          Early Warning Signs of Rejection (RSVP):<\/b><\/h3>\n
            \n
          • R<\/b>edness<\/li>\n
          • S<\/b>ensitivity to light (photophobia)<\/li>\n
          • V<\/b>ision reduction<\/li>\n
          • P<\/b>ain<\/li>\n<\/ul>\n

            Post-Transplant Visual Rehabilitation:<\/b><\/h2>\n

            Because donor and host corneal curvatures rarely match identically, residual refractive errors and regular\/irregular astigmatism are common. Visual acuity is optimized using corrective spectacles, rigid gas permeable (RGP) lenses, hybrid lenses, or scleral contact lenses once healing stabilizes. Refractive laser enhancements (PRK or LASIK) may be considered only after complete graft stabilization and total suture removal.<\/p>\n

            \n","protected":false},"excerpt":{"rendered":"

            What is Corneal Transplantation and How is it Performed? Corneal transplantation is a surgical procedure in which a patient’s damaged or diseased cornea is replaced with healthy donor corneal tissue. There are two primary types of transplantation: if the full thickness of the cornea requires replacement, the procedure is termed Penetrating Keratoplasty (PKP); if only […]<\/p>\n","protected":false},"author":2,"featured_media":4843,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[93],"tags":[],"class_list":["post-4893","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-93"],"_links":{"self":[{"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/posts\/4893","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/comments?post=4893"}],"version-history":[{"count":1,"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/posts\/4893\/revisions"}],"predecessor-version":[{"id":5106,"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/posts\/4893\/revisions\/5106"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/media\/4843"}],"wp:attachment":[{"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/media?parent=4893"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/categories?post=4893"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsiamakzarei.com\/en\/wp-json\/wp\/v2\/tags?post=4893"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}