Recommended For Artificial Corneal Transplant
Loss of optical clarity occurs when the cornea is damaged by injury or disease. When irreversible, blindness occurs. To date, the widely accepted treatment is transplantation with human donor corneas. However, in many countries, the demand for good quality tissue exceeds the supply. In addition, some conditions are not amenable for donor transplantation. Hence, artificial corneal substitutes are using to address the shortage of human donor tissues as well as the current disadvantages in some clinical indications, which include immune rejection.
There are several reasons why you may need a new cornea:
• Complications from LASIK or PRK surgery
• Degenerative eye conditions called corneal dystrophies which affect the clarity of the cornea.
• Scarring from previous infections, such as bacterial, fungal, and viral (e.g., Herpes simplex) infections.
• Keratoconus, a condition associated with thinning of the cornea and an irregular shape.
The cornea is the clear, front window of the eye. It helps focus light into the eye so that you can see. The cornea is made of layers of cells. These layers work together to protect your eye and provide clear vision. Your cornea must be clear, smooth and healthy for good vision. If it is swollen or damaged, your eyes cannot focus the light properly. As a result, your vision is blurry, or you see glare. If your cornea cannot heal or repair itself, your ophthalmologist may recommend a corneal transplant.
How It Is Performed
As a summary of the procedure, the artificial corneal transplant surgery resembles a miniature telescope that is inserting into a corneal transplant and putting stitches into the patient’s cornea. The surgeons remove the natural lens, if still present. If the patient has already had cataract surgery, the lens implant is left alone. Then the surgeons place a soft contact lens onto the eye for comfort, and you must wear them every day. The surgery usually takes about an hour and a half to perform.
Artificial corneas have been using for over 50 years. However, it has only been within the last few years that these devices have become reliably successful. For most patients, human donor tissue still provides the best results. But in patients who are at high risk for failure with a human donor, an artificial corneal transplant can provide excellent visual results with a good risk-to-benefit ratio.
Most patients tolerate the procedure very well and have minimal postoperative pain. On the first day, post-op care includes topical prednisolone acetate 1%, and a topical fluoroquinolone; both administered four times daily. The long-term use of topical corticosteroid is unnecessary in many cases. Your vision may be blurry for a period of time after surgery. For some people, recovery time may take 6 to 12 weeks to get the full benefits of surgery and to see as clearly as possible.
The risks of artificial corneal transplant surgery include:
Before And After
• Vitreous hemorrhage- bleeding inside the eye
• Endophthalmitis- an infection inside the eye
• Glaucoma- elevated intraocular pressure
• Retro prosthetic Membrane- scar tissue forming behind the keratoprosthesis blocking the vision.
Artificial corneal transplant provides excellent long-term (many years) stability and safety. Its optical system can provide normal vision if the rest of the eye is undamaged. The surgery is reversible at any time.
What are the artificial corneal transplant procedure steps?
1. Application of antibiotic and anesthetic eye drops to the ocular surface.
2. Creation of an 8-mm diameter corneal dissection and 3.5-mm diameter circular incision using a femtosecond laser.
4. Removal of the central 3.5-mm disc of anterior corneal tissue.
5. Insertion of the artificial cornea inside the corneal pocket and placement of the artificial cornea central optic inside the trephination opening.
How Will the Artificial Corneal Transplant Procedure Affect My Vision?
The goal of this surgery is to restore clarity and refractive function of the cornea and improve vision.
How Much Does the Artificial Corneal Transplant Cost?
For patients who do not have health insurance, the average cost of surgery can range from $13,000 to $27,000 or more.
This content is written and reviewed by our medical content team in February, 2019.