If we’re talking about the front part of the cornea that is affected, we can do what we call an anterior lamellar keratoplasty. That is a partial thickness corneal transplant, where we remove the top layers of the cornea.
Why we do that? Because it is a more disease-specific treatment, the rejection rate is extremely low, and the success is very good. Especially if the patients are young and active, you don’t want to do a full-thickness graft and put them at risk of graft rejection.
If the back of the cornea or the lining of the cornea is affected, for example, Fuchs’ corneal dystrophy, then the advanced treatment means that we can remove the lining of the cornea. It’s like a clean film that you can wipe off, and then you implant a new layer of cells on the back of the cornea. You can call this as cell therapy more than actually tissue transplantation. It’s very effective with very fast recovery. We call it Descemet membrane endothelial keratoplasty, or the DMEK, D-M-E-K. This is the latest generation of corneal transplantation to treat diseases affecting the lining of the cornea.
Advanced technology means that now we can use lasers to cut the cornea rather than using blades, and that results in faster recovery and better visual outcomes of the surgery.
In summary, there are various types of corneal transplantation, or what we call keratoplasty.