CORNEA GRAFTING

Geeta Mohan
 Cornea Grafting

• Corneal transplantation, also known

as corneal grafting, is a surgical procedure
where a damaged or diseased cornea is
replaced by donated corneal tissue (the graft).
 Cornea Grafting

When the entire cornea is replaced it is known

as penetrating keratoplasty
When only part of the cornea is replaced it is
known as lamellar keratoplasty.
Keratoplasty simply means surgery to the
cornea. The graft is taken from a recently dead
individual with no known diseases or other
factors that may affect the chance of survival
of the donated tissue or the health of the
recipient.
 Cornea Grafting

• The cornea is the transparent front part of

the eye that covers the iris, pupil and anterior
chamber.
• The cornea is the outermost transparent layer
of the eye that is seen in the front. The cornea
is made up of three layers - an epithelium, a
stroma and a single endothelial layer of cells.
• The cornea is curved and it protects the eyes.
The convex helps in refraction or bending of
the light. Between the cornea and the iris is the
anterior chamber filled with aqueous humor.
Cornea Grafting

• Blindness is due to various reasons, such as

defect in the formation of the eyes, problems
associated with the retina, damage to the
optic nerve or due to the cornea becoming
opaque or distorted or damaged
Cornea Grafting

• The cornea being the outer most layer is

exposed to the environment. The cornea can
become opaque due to injury caused by –
• Harmful chemicals.
• Presence of ulcers
• Deficiency of vitamin A in children can result in
cornea becoming opaque.
• The cornea could become scarred due to
herpetic keratitis , fungal keratitis
• The cornea can be defective at birth becoming
cone shaped, the condition is called
keratoconus.
Cornea Grafting
Cornea Grafting

The matching of the blood types is needed. The HLA

antigen is present in the endothelial cells and the
stromal cells.
 Cornea grafting

• Keratoplasty– Surgery to cornea

PENETRATING KERATOPLASTY – Full thickness corneal transplant
 Cornea grafting

ENDOTHELIAL KERATOPLASTY- Selectively replaces only the innermost

layer of cornea (endothelium ) and leaves the overlying healthy tissue
intact
Cornea Grafting

The only organ that can be successfully grafted is the

cornea. This is because they lack vascularisation and the
lymphocytes do not reach them.
90% of the cases are successful, but in 10% of the cases
there has been rejection.
The early rejection is seen within 2 to 3 days and is cell
mediated. There is accumulation of lymphocytes and the
cornea becomes swollen.
Late rejection also occurs after several weeks or months
due to antibody production. The rejection reaction occurs
due to the recipient’s cornea being damaged by an
inflammatory disease which he suffered from previously. In
such cases his cornea would have been exposed to blood and
lymph supply.
 Cornea Grafting

To prevent rejection corticosteroid is used in the form

of eye drops that has to be used once or twice a day.
The eye drop containing cyclosporine is used.
The recipient is treated with immunosuppressors like
Azathioprine before grafting.
In cases where there has been repeated rejection
apart from the immune suppressor treatment
HLA test is also recommended to find the most suited
donor.
Cornea Grafting
Cornea Grafting

Credits
Wikipedia