What is a corneal transplant and when is a corneal transplant needed?

SAMER HAMADA EXPLAINS WHAT A CORNEAL TRANSPLANT IS AND WHEN IT IS NEEDED

The cornea is the front part of the eye. If a disease affects the cornea, then the cornea becomes either distorted in terms of shape or opacified. It will be scarred and not clear anymore, and sometimes the treatment is not enough, and the patient might need surgical intervention. That’s what we call corneal transplantation.

Now, the advanced technology and advanced knowledge about the cornea allows us to do a partial thickness corneal transplantation. Therefore, we no longer do a full-thickness corneal transplant unless that’s absolutely a necessity. The trend now is to do a partial-thickness corneal transplant, and it depends on which part of the cornea is diseased.

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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. 

About the expert

Mr Samer Hamada | Consultant Ophthalmologist and Corneal Surgeon

MD, MSc, DO (hons), FRCSEd, FRCOphth I am Samer Hamada, founder and consultant ophthalmic surgeon with over 20 years’ experience in ophthalmology. I am a world-renowned specialist in cornea, cataract and refractive surgery. I’m not only a leading surgeon but also the only dual fellowship trained in corneal diseases in children from reputable institutions in the UK. At Eye Clinic London I work closely with other consultant ophthalmologists, optometrists and orthoptists to achieve the best outcomes for our patients. Our main aim is to make sure our patients get the safest and best treatments available to them. We put your safety before anything else so you can rest assured that if you choose us you will be in the best and safest hands.

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