Corneal transplants are the most common organ transplants performed across the globe, and 33,000 people in the US each year undergo corneal transplant surgery. Severe keratoconus is one of the diagnoses linked to corneal transplantation. However, a research article in Cornea in 2017 noted that the traditional (penetrating keratoplasty) corneal transplant surgery – involving all three main layers of the cornea – is decreasing in the US. The main reason is the development of alternative treatments for severe keratoconus over the past decade.
If you have keratoconus, a consultation at the Precision Keratoconus Center may help you to understand your treatment options.
What are the Risks Associated with Corneal Transplantation?
The Mayo Clinic describes the following as risks associated with corneal transplant surgery:
- Eye infection consequent to surgery;
- Rejection of the donor cornea;
- Increased risk of cataract formation;
- Increased risk of glaucoma
- Swelling of the cornea
According to the Cornea Research Foundation of America, visual recovery after penetrating keratoplasty often takes 1-2 years. However, around 97 percent of corneal transplant operations are able to restore vision in the transplant recipients (per the Eye Bank Association of America).
Issues Related to Bilateral Corneal Transplants
Keratoconus-afflicted people who require bilateral corneal transplants usually need to wait around one year after surgery in the first eye before undergoing a transplant in the other eye. Yet, this type of corneal transplantation may be necessary to relieve pain, recover vision, and enable the ability to independently perform normal activities of daily living. It may also enable a person who left employment due to significant vision loss to return to full-time employment.
Alternatives to Corneal Transplantation
One alternative to traditional corneal transplantation in people with severe keratoconus is called Bowman Layer transplantation. As reported in Ophthalmology Times in 2016, this surgical procedure can both halt the progressive vision loss and flatten the cornea into a more normal position – enabling the keratoconus-afflicted person to continue to wear contact lenses without enduring a high degree of pain.
Meanwhile, Deep Anterior Lamellar Keratoplasty (DALK) involves transplantation of only the front and middle layers of the cornea. A report of the American Academy of Ophthalmology suggests that DALK can be a viable alternative to penetrating keratoplasty if the endothelium layer of the cornea is functioning normally.
What is Corneal Transplant Rejection?
Organ rejection in corneal transplant patients can be reversible or irreversible. According to the College of Optometrists, at least one episode of rejection occurs in 30 percent of corneal transplants. Organ rejection (whether a cornea or any other transplanted organ) occurs because the recipient’s body recognizes the transplanted organ as a “foreign” entity, and the immune system attacks it.
Five symptoms of rejection of the transplanted cornea are:
- Increased sensitivity to sunlight and/or artificial light (photophobia);
- Blurred vision;
- Eye pain;
- Excessive watering of the eye (epiphora);
- Eye that becomes bloodshot (red)
One of the foremost reasons for rejection of the corneal transplant is failure to adhere to the daily anti-rejection medication (corticosteroid) eye drop regimen. For people who reject human donor corneas due to innate immune response despite anti-rejection eye drops, an artificial cornea may be transplanted.
Psychological Benefits of Cornea Transplantation
Loss of eyesight is linked to clinical depression. Reported in an article in 2018 in the Journal of Ophthalmology was that keratoconus-afflicted people with severe vision loss were more likely to experience clinical depression than keratoconus-afflicted people with minimal vision loss. A successful corneal transplant may improve the mental health of a person with severe keratoconus through enabling improved vision. If your have keratoconus, schedule an appointment at one of the numerous Precision Keratoconus Center offices. This may help you to better understand the diverse options for treating keratoconus, as well learn more about corneal transplants.