Realizamos trasplantes de córnea de reemplazo parcial y de espesor total
Un trasplante de córnea implica reemplazar una córnea enferma o con cicatrices por una nueva. Cuando la córnea se vuelve turbia, la luz no puede penetrar el ojo para alcanzar la retina sensible a la luz. Puede causar una visión deficiente o ceguera. Las córneas generalmente se donan desde un banco de ojos para este procedimiento, y se necesitan gotas para los ojos después de la cirugía.
When possible, the eye care specialists on the medical staff at Baylor Scott & White Health will do a partial replacement of the cornea such as an endothelial keratoplasty or anterior lamellar keratoplasty. These newer surgeries are usually safer and result in quicker return of vision.
However, many conditions are still best managed with a full thickness corneal transplant called a penetrating keratoplasty.
Corneal transplant eligibility
To determine who is a good candidate for a corneal transplant, the patient must be evaluated. Patients are considered suitable if they have considerable corneal deterioration. Patients with corneal deterioration will have cloudy vision and are not able to see clearly through their affected eye.
Patients are usually referred for a transplant by their ophthalmologist and are scheduled for a corneal consultation with us if the physician suspects corneal damage.
Corneal transplant surgical options
Baylor Scott & White Health offers the latest in corneal transplant techniques.
Queratoplastia endotelial con membranas de Descemet (DMEK)
This is the newest type of corneal transplantation that is only being done at a limited number of locations.
During this procedure, the surgeon removes the cells in the back of the cornea and replaces them with the identical tissue from the donor. The front of the cornea is left unchanged except for a small incision.
This surgery usually only requires one stitch compared to sixteen or more for a typical cornea transplant.
Vision returns much quicker after this surgery and there often is complete visual rehabilitation by four weeks.
The highest percentage of patients are corrected to 20/20 after this surgery compared to other types of corneal transplants.
This is usually the preferred transplant for Fuchs dystrophy.
Queratoplastia endotelial con stripping de Descemet (DSEK)
During this procedure the cells in the back of the cornea are removed and replaced with a thin piece of cornea tissue which is attached with an air bubble.
It is similar to DMEK, but utilizes a thicker piece of tissue. Some people are not a candidate for DMEK, but are still a good candidate for this surgery.
It usually requires three stitches and vision may be finalized as soon as six weeks.
This is usually preferred for bullous keratopathy and sometimes for Fuchs dystrophy.
Queratoplastia lamelar anterior
In this partial replacement procedure only the front part of the cornea is removed and replaced with the front of another cornea. It is attached with a very fine thread which may be left in place for months or even years.
This type of surgery decreases the risk of rejection, damage from trauma, and risk of the surgery.
This surgery is often used for keratoconus, and corneal scars.
Queratoplastia penetrante
This surgery removes the full thickness of the central cornea and can be used when there is damage to all layers of the cornea.
It also uses a very fine thread that may be left in place for months or even years.
This is also often used for infections, and other conditions with severe damage.
Risks and benefits of corneal transplant
El principal beneficio del trasplante de córnea es la restauración total de la visión.
The risks of corneal transplant include:
- Astigmatismo, que puede ser causado por una ondulación en el tejido durante la cirugía. Se pueden necesitar lentes correctivos para corregir este problema.
- Glaucoma (presión alta en el ojo que puede causar pérdida de visión).
- A veces, el cuerpo rechaza el tejido corneal. La medicación se le da al paciente después de la cirugía de trasplante para ayudar a su cuerpo a aceptar el tejido corneal. Sin embargo, en un pequeño número de pacientes, el cuerpo rechaza la córnea del donante, lo que produce una visión nublada. Si ocurre el rechazo, se puede realizar un segundo trasplante.
- Ceguera si la cirugía no tiene éxito.
Que esperar
Eligible patients must be healthy enough for surgery to receive a donor cornea. Patients undergoing a corneal transplant will be able to use any donated cornea. Unlike other types of transplants, corneal transplants do not require the donor and recipient to have the same blood type.
Sin embargo, a veces el cuerpo rechaza el tejido extraño. Se administra medicamento antirrechazo al paciente después de la cirugía de trasplante para ayudar a su cuerpo a aceptar el tejido corneal. Si ocurre el rechazo, se puede realizar un segundo trasplante.
¿Quiénes son los donantes?
Los donantes son personas fallecidas que, antes de morir, acordaron donar sus órganos. Baylor Scott & White coordina con bancos de ojos, como el Lonestar Lion's Eye Bank en Manor, Texas, para asegurar las córneas para el trasplante.