It is the surgical replacement of a diseased and / or opaque cornea by a human graft from a recently deceased human donor. The graft is tested in an eye bank to check its transparency and verify the absence of transmissible infectious disease.
This transplantation may concern the entire corneal thickness and is called a transfixing keratoplasty. It can be only partial and concern either its superficial layers or its deep layer; it is then a lamellar graft.
The patient is registered on a national waiting list. The delivery of a graft has become very fast. The graft is free of charge. To date, there is no synthetic graft.
It is not so much the age which counts as the inconvenience caused, either in term of visual function decrease, or in term of eye pain, and thus the appreciation of the visual benefit that corneal replacement can bring.
All patients are suitable for surgery regardless of age and medical condition. The procedure lasts 30 to 60 minutes and can be carried out indifferently under local or general anesthesia.
The only reasons why surgery would be inappropriate are insufficient visual discomfort and/or concomitant ocular disease that would not permit a postoperative significant visual acuity improvement.
Corneal transplantation causes more discomfort than true pain
If vision improvement is observed after a few weeks, recovery of satisfactory visual acuity requires several months to a year.
Rejection of the graft is rare; it results in an opacity of the graft, in no case by the loss of the eye. It can occur at any time after a corneal transplant, even after several years. Its rate is variable and is usually correlated to the initial corneal disease.
It is treated first medically, with anti-inflammatory and anti-rejection eye drops, and, if necessary, by a surgical replacement of the graft.
