Corneal transplant Brisbane
Dr. Cameron McLintock, an experienced ophthalmologist, has been a part of this journey for countless patients in Brisbane, offering them a chance to see the world anew. Specialising in eye transplant surgery, including corneal transplant surgery, Dr. McLintock is dedicated to providing top-tier care and treatment to those affected by various corneal diseases.
Corneal diseases can affect vision in profound ways. They blur the world, make objects indistinct, and prevent you from living your life to the fullest. A corneal transplant, or cornea replacement, offers the promise of restored vision and independence.
What is the cornea?
What is a corneal transplant?
The term corneal transplant (also known as a corneal graft) refers to a group of operations in which the cornea is removed from an organ donor and used to replace the diseased cornea of a living person. There are several types of corneal transplants including Penetrating keratoplasty (PK), Descemet Membrane Endothelial Keratoplasty (DMEK), Descemet Stripping Endothelial Keratoplasty (DSEK) and Deep anterior Lamellar Keratoplasty (DALK).
Penetrating keratoplasty is a corneal transplant in which a diseased circular, full thickness section of the cornea is removed and replaced with a similar sized transplant from a donor cornea. It is performed in cases where there is disease which involves the entire thickness of the cornea. The corneal transplant tissue is stitched to the eye using tiny sutures. The manner in which these sutures are inserted must be done precisely and with exact tension to ensure that the corneal transplant is well secured and that it’s shape is regular (to ensure good future vision). The stitches remain in place for 12 to 18 months until the transplant has embedded sufficiently to the eye. After this the stiches are removed (this is usually possible in the clinic). Once the stiches are removed, further measures may be required to achieve the best possible vision. These include glasses, contact lenses, laser surgery and artificial lens implant surgery.
Descemet Membrane Endothelial keratoplasty (DMEK).
Prior to the development of DMEK and DSAEK, treatment of corneal diseases affecting the endothelium required a full thickness corneal transplant (penetrating keratoplasty), after which best vision is not achieved for 12-18 months.
After DMEK surgery, the best vision is achieved within 3 months. The likelihood of the immune system rejection a DMEK graft is significantly less than in penetrating keratoplasty or DSAEK. After DMEK surgery, the patient must lie on their back for 2 hours and then for 45 minutes in every hour overnight. This ensures that the graft adheres well to the inner side of the cornea.
Deep anterior lamellar keratoplasty (DALK)
DALK is a type of corneal transplant used in diseases of the cornea where the inner layer of the cornea (endothelium) is healthy. In such surgery, the front 80-90% of the cornea is removed and replaced with corneal tissue from an organ donor. The donor cornea is sutured (stitched) into place.
During the operation, benefits of DALK compared to Penetrating Keratoplasty include a reduced risk of complications during surgery such as bleeding and infection which can threaten vision if they occur. Following surgery, there is a much lower risk of the body’s immune system rejecting the transplant as the main target of the immune system in corneal transplant rejection is the inner layer which has not been transplanted in cases of DALK. Another major benefit of DALK surgery is a much better long term survival compared to Penetrating Keratoplasty (PK).