Keratoplasty and cornea pathology treatment

Cornea surgeries to restore the shape and functioning of cornea and to eliminate defects and deformations, either inherent or caused by injuries or diseases, are called keratoplasty. The key of this surgery is to replace a part of the cornea with a donor transplant. The graft may be implanted in the cornea in the cornea stratum or be placed on the surface or replace the cornea itself.

Vision distortions caused by abnormality of cornea due to disturbance in transparency or shape are irreversible and cannot be corrected by standard optic means (glasses or contact lenses). The only possibility in such cases is a keratoplasty surgery (partial or total replacement of the cornea damaged area).

When keratoplasty is used?

Below are the cornea abnormalities requiring a keratoplasty:

• Keratoconus;
• Cornea leucomas (ambustial or dystrophy);
• Congenital or acquired cornea dystrophy;
• Cornea cicatrix caused by injuries, surgeries or inflamations;
• Traumatic cornea defects.

Until recently cornea transplantation have been considered to be complicated. The main problem was alck of proper definitions in the Doors Law. Moreover it has been difficult ot get the proper donor tissue: only few doctors has had access to the transplants bank. Lots of people had been on the waiting list for donor’s cornea for years.
It is worth mentioning as well that the tissue for transplantation has had a limited storage life – 24 hours. The decision to carry out a transplantation was to be taken within a very short time which was not easy for a patient sometimes. The choice of grafts was very limited and no research on the quality and viability of the tissue and the number of endothelial cells was made.

There could be no guarantee that the donor tissue would engraft, the cases when it was turning opaque and the second transplantation was necessary were quite often. Now this problem has been solved! From July 2011 Excimer ophthalmology clinics offers the unique procedure – keratoplasty.

Keratoplasty is replacement of a damaged cornea area. The brand name of the material used as a graft at Excimer clinics is “Cornea Transplant”. This unique material has passed the clinical trials and has all the relevant registry papers and certificates from Roszdrav (Russian Health Ministry).

Thanks to the new technology and the biomaterial storage system, the Excimer doctors now are happy to help patients suffering from cornea pathology.

• The preparation for the surgery starts with a complete visual system check that allows doctors to detect the disorder at very early stages and determine the indications for a surgery and forecast the result.
• In the course of the surgery, the surgeon using microsurgery tools and the femtosecond laser, shapes a corneal graft and separates the damaged cornea piece. Then they transplant the “ Cornea Transplant” of exactly the size of the previously shaped graft, suturing it with a special material to the periphery of the cornea. At the end of the surgery they apply a dressing or a special protective contact lense on the patient’s eye.
• At Excimer clinics keratoplasty is performed on the out-patient basis under general anesthesia or using local (parabulbar) anesthesia with state-of–art medications that spare the load on cardio-vascular system and are easily tolerated by patients of various age groups. Following the surgery and doctor’s examination the patient goes home and this obviously facilitates the maximum comfort recovery.
• Post-keratoplasty rehabilitation period takes up to one year and this is due to the structure of cornea. During this period the patient should regularly receive observations from his Excimer doctor who monitors the recovery dynamics. Sutures are usually removed in 6 to 12 months after the surgery.

In most cases results of keratoplasty are successful: cornea stays transparent, good visual performance is achieved. The expertize of Excimer clinics will manage the post-surgery astigmatism if any using the excimer-laser correction procedure.

Special features of Excimer keratoplasty

• The new technology allows the Excimer doctors to treat the cornea abnormalities problems on a new quality level;
• The equipment, disposable instruments and expendable materials used at Excimer clinics are of the world acknowledged standards and have passed the strict clinic trials and have all the relevant certificates and approvals;
• Post-operative complications and rehabilitation period are brought to the minimum, the most positive results are achieved;
• The Excimer doctors have permanent access to the bio-material bank and the surgery depends only on the patient’s will and the individual indications for a keratoplasty;
• The biomaterial (“Cornea Transplant”) is selected in accordance with the standards of the world leading ophthalmology clinics, repeated surveys: biological, virological and endothelial cell layer are performed, this altogether allows to make a forecast on the vitality of the material and the outcome of the surgery;
• Unlike the materials used before, the “Cornea Transplant” is better accepted, has lower risk of opacity.
• Excimer ophthalmosurgeons achieve better optic performance using this biomaterial.