What is it?
The cornea is the transparent tissue that lies in front of our eye, just as if it were the “glass piece of the clock” and has the function of allowing the light entering the eye to be focused on the retina.
Corneal transplant is a surgery where the cornea’s central portion is replaced by a healthy donor cornea (Fig. 1). A good analogy is to think of replacing the glass piece of a watch that has become frosted or has lost its transparency. The new cornea is fixed with a special very fine nylon thread (Fig. 2 and Fig. 3), with the aid of a surgical microscope. The patient receives local anesthesia and does not need to spend the night in the hospital. The procedure takes about an hour.
The number of penetrating transplants, or of total corneal thickness, has decreased, because with the advent of more accurate surgical techniques, it has become possible to transplant only the diseased layers of the cornea (Fig. 4). This means that the transplant can be partial, leaving the cornea’s good portion intact and, thus, reducing the possibility of post-surgical rejection..
The main causes of corneal transplant in Brazil are: keratoconus (Fig. 5), Bullous keratopathy (corneal swelling after cataract surgery – Fig. 6), Corneal opacities (Fig. 7), Fuchs’ dystrophy (corneal endothelial cell weakness) and infections (Fig. 8).
Corneal transplant is currently a very safe and effective surgery, although its success depends, in addition to the surgical technique, on adequate postoperative follow-up. Transplant rejection is the most feared complication and should be handled with urgency.