Corneal Transplant

Replacing clouded or damaged corneas

Overview

A corneal transplant, or keratoplasty, replaces damaged or diseased corneal tissue with donor tissue. In penetrating keratoplasty, a full thickness disc of cornea is replaced and sutured in place. The first successful human corneal transplant of this kind was performed by Eduard Zirm in 1905 in what is now the Czech Republic, among the earliest successful human tissue transplants of any kind. Lamellar techniques replace only the diseased layers. Deep anterior lamellar keratoplasty, DALK, replaces the front layers while preserving the endothelium of the recipient and is used for keratoconus and anterior scars. Endothelial keratoplasty, DSAEK and DMEK, replaces only the inner endothelial layer through a small incision and has become the main treatment for Fuchs dystrophy and other endothelial failure. Because the cornea normally lacks blood vessels and benefits from immune privilege, rejection rates are lower than for many solid organ transplants, but graft rejection remains a recognized risk. Eye banks recover, evaluate, and distribute donor corneas, and limited access to donor tissue remains a barrier in many parts of the world.