Restore your eye health with corneal graft surgery
In the toggles below, we have provided everything you need to know about corneal graft surgery
The cornea provides 2/3 of the optical power of the eye. The lens provides the last third. The main role of the cornea is to converge light (light rays) through the anterior chamber and other posterior structures of the eye to the retina. This optical power is possible thanks to the transparency of the cornea, the corneal curvature and its contact with the ambient air. The cornea is made up of four layers:
- Epithelium
- Stroma
- Dua layer
- Endothelium
And two membranes:
- Bowman’s membrane
- Descemet’s membrane
Common conditions that affect the cornea
Corneal endothelium condition : Cornea Guttata/Fuchs’ Endothelial Dystrophy
In Fuchs’ Dystrophy, fluid builds up in the clear layer of your eye, causing your cornea to swell and thicken. This can lead to glare, blurred or cloudy vision and eye discomfort.
Keratoconus
Keratoconus is an eye condition whereby your cornea thins and gradually bulges outward into a cone shape. This can cause blurry, distorted vision. If your keratoconus becomes advanced and your cornea becomes scarred, the best treatment is a corneal transplant.
Pterygium
A pterygium is a pinkish, triangular tissue growth of the cornea of the eye. It can be unsightly and cause chronic irritations. When it spreads over the cornea, it can cause visual disturbance. Extrinsic factors, particularly solar radiation and dust, play a key role in its genesis.
The treatment of pterygium is surgical. In our center, we can remove the pterygium and perform a conjunctival autograft to limit recurrence.
We use corneal grafts to treat damage to the corneal endothelium. The endothelium is a thin, single-celled layer that lines the inner surface of the cornea. Its cells (endothelial) have the function of regulating the amount of aqueous humor in the eye, which naturally infiltrates the cornea.
The endothelial cells can become less numerous due to:
- Pathologies: the best known is cornea guttata (Fuchs dystrophy)
- Trauma (most often surgical): for example a difficult cataract operation or certain intraocular lenses placed against the inner face of the cornea to correct myopia.
Endothelial cells cannot regenerate. When their number is too low, the endothelial pump function becomes insufficient. The quantity of liquid contained in the thickness of the cornea then becomes too great. This is called corneal edema. The cornea loses its transparency; vision is impaired.
The current surgical technique – endothelial grafting – involves bringing in new endothelial cells. This technique makes it possible to replace only the diseased part of the cornea: the endothelial layer.
The endothelial transplants are a way of treating the corneal endothelium without performing a total corneal transplant. The graft is made up of the corneal endothelium, Descemet’s membrane and part of the stroma.
These techniques are recognized for their rapid visual recovery. It requires great skill and significant experience of the surgeon to ensure postoperative visual quality in the patient.
We have performed this surgery in our clinic since 2007. Our experience allows us to guarantee the effectiveness, safety as well as the lifespan of the graft.
Risks include:
- Eye infection
- Increased risk of clouding of the eye’s lens (cataract)
- Pressure increase within the eyeball (glaucoma)
- Rejection of the donor cornea
- Swelling of the cornea
Transfixing cornea transplant
The transfixing corneal transplant (or transfixing keratoplasty) is a surgical technique which consists in replacing a central corneal disc of full thickness comprising the epithelium, the stroma, the membrane of Descemet and the endothelium of part of the cornea thanks to a 360 degree incision. A graft of the same diameter is then placed and sutured by separate stitches or by an overlock to the collar of the recipient’s cornea. These points are removed 2 years after the transplant.
We operate on an outpatient basis. You enter the clinic the morning of the operation, and you can go home the same evening.
We can give anesthesia by neuroleptanalgesia or by general anesthesia.
The intervention lasts about 20 minutes. It consists of:
- Removing a thin layer of tissue from a corneal graft containing healthy endothelial cells
- Removing the diseased endothelial layer through a small incision
- Inserting a coverslip containing healthy endothelial cells through the incision, so they press flat against the face of the cornea
Visual recovery takes about one month (compared to 1 year with a transfixing graft). Visual improvement is on average 6/10 and can reach 10/10.
After the operation, it is necessary to wear glasses to correct the induced astigmatism. Still, the correction is generally weak, unlike the required correction after a transfixing transplant which induces astigmatism of 4 to 5 diopters on average.
The postoperative effects are generally painless. Sometimes people experience the feeling of a grain of sand present during the first hours. Headaches are possible.
After surgery, you will need to use eye drops for nine months. This is to prevent postoperative infection and reduce the risk of rejection.
During the week following the operation, you must:
- Avoid dusty atmospheres
- Do not rub your eye
- Disinfect your hands often with a hydroalcoholic gel, especially when instilling eye drops
Your postoperative follow-up will consist of several check-ups:
- The day after the operation
- At 8 days
- At one month
- At three months
- At one year
- Then once a year after that
Bringing world-class expertise to patients in Lyon
We’re honoured to be members of these prestigious professional organisations
Liens vers des ressources faisant autorité sur la greffe cornéenne
Suivez les liens ci-dessous pour plus d’informations sur la greffe cornéenne
Dr. David Donate
Ophthalmologist – Refractive surgery specialist
20 years’ experience and 20000 successful vision correction treatments
With over 20 years of experience performing more than 20000 successful eye procedures, and a repertoire of academic publications and research, Dr. David Donate has earned himself an international reputation.
At his state-of-the-art clinic in Lyon, Dr. Donate follows a specialised method called, The Donate Method, to ensure his patients feel confident about their vision correction journey. Combined with the highest quality pre-op and post-op appointments, expert precision solutions and top technology, Dr. Donate is perfectly positioned to deliver the best possible outcome for his patients.
