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현재 페이지 위치 : Organ Transplantation Center > Transplant Program > Cornea Transplant > Overview

Overview

What Is a Cornea Transplant?

Cornea transplantation is surgery that replaces the cornea. The cornea is the foremost part of the eye and works as a window where the light goes through first to create an image. This is the only eye part where transplantation is possible. As in Picture 1, an opaque cornea (due to cornea clouding) makes images look unclear. In this case, patients can receive a clear and healthy cornea as in Picture 2.

Types

The cornea is divided into the epithelium, stroma, and endothelium. Depending on the extent of the lesion, the entire layers are transplanted (penetrating keratoplasty) or only a part of it is grafted (lamellar keratoplasty).

Regarding partial cornea transplantation, deep anterior lamellar keratoplasty and descemet’s membrane stripping endothelial keratoplasty are most common. The former is for patients whose legion is not extended to the endothelium (e.g. Keratoconus). In this type of surgery, the recipient’s endothelium is kept intact and only the epithelium and the stroma from the donor are transplanted. On the other hand, the latter is to transplant the endothelium only.

Penetrating keratoplasty has a long history of wide application. Compared to lamellar keratoplasty, it takes shorter and has more indications.
However, lamellar keratoplasty is trickier and takes longer while it guarantees a relatively faster vision and wound recovery.
Also, it shows a less chance of rejection reactions and thus, a shorter use of steroid as an immunosuppressant is possible.

In every type of cornea transplantation, complications such as rejection reactions can occur. If in some cases, the function of the graft deteriorates years later, further operations are necessary.

Indications and Contraindications

Indications

In general, cornea transplantation is used for four major purposes: vision improvement, support for the eye structure, treatment of cornea diseases that do not respond to medications, and aesthetics. Clinically, traumatic cornea diseases, keratoconus, keratitis, and bullous keratopathy are the most common indications in Korea.
Transplantation is possible only when the lesion is limited to the cornea. Lesions in other parts of the eye (e.g. retina diseases and optic neuropathy) are not considered indications. If the lesion exists in only part of the cornea, lamellar keratoplasty is applicable. Otherwise, penetrating keratoplasty is an option.

Contraindications

  • Donor Contraindications
    • Unknown causes of death
    • Death by unknown central nervous system diseases
    • Creutzfeldt-Jakob disease (CJD)
    • Acute sepsis
    • Acute viral hepatitis
    • Ophthalmopathy (malignant tumors, uveitis, retinitis, etc.)
    • Hepatitis B carriers
    • AIDS
       
  • Recipient Contraindications
    • Neuroparalytic keratitis
    • Exposure keratitis
    • Uncontrollably sever dry eye syndrome

For registration as a cornea donor, please contact the Center or the KONOS.

* The Organ Transplantation Center of SMC
+82-2-3410-1126, +82-10-9933-1126