Your surgeon will recommend one of three surgical options for cornea transplant.
- Penetrating keratoplasty
- Partial thickness keratoplasty (DALK- Deep Anterior Lamelar Keratoplasty)
- Endothelial keratoplasty
The method chosen by your surgeon depends on the cause of the damage to the cornea, the condition of your cornea and your unique needs. In some cases, a cornea transplant may not improve the visionor your surgeon may recommend avoiding surgery.
Regardless of the type of graft you receive, your new cornea will come from a dead human organ donor. Each cornea donor undergoes a thorough examination to make sure it is safe for transplantation. The cornea consists of three layers of tissue. Each surgical option focuses on a specific layer or layers.
Penetrating keratoplasty is also called a full-thickness cornea transplantation, in this procedure, your surgeon uses a small circular blade to remove the entire central part of the damaged cornea and replaces it with a healthy piece of cornea donor of the same shape.
DALK– Deep Anterior Lamellar Keratoplasty
If the inner layer of your cornea is healthy, but the middle and outer layers are damaged, your surgeon may perform a partial-thickness cornea transplant. During this surgery, your surgeon removes the middle and outer layers of your cornea and replaces them with healthy corneal tissue.
This procedure can help if the inner layer of your cornea, the endothelium, is damaged. This thin layer of endothelial tissue is called the Descemetmembrane. Surgeons perform two types of endothelial keratoplasty operations:
- Descemet stripping automated endothelialkeratoplasty – DSAEK
- Descemet membrane endothelial keratoplasty – DMEK
Each procedure removes the damaged endothelial tissue and replaces it with healthy donor tissue. Unlike other keratoplasty procedures, fewer or no stitches are needed with endothelial keratoplasty procedures. In contrast, an air bubble is used to keep the donor cornea in place. To increase the chances of success, you will need to place yourself face down for a few days after the operation so that the bubble can hold the cornea.