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Project HIE STANDARD
The Cornea is a dime sized piece of tissue that covers the iris and pupil and along with the lens, helps the eye to focus.The Cornea Transplant is actually a procedure that dates back to over a hundred years ago. People often needed cornea transplants to correct mild blindness. Though blindness was a predominant reason, people also used this for cataract removal and other eye disorders. Currently, cornea transplants are performed for various health reasons. These include pain relief, emergency care in the instance the cornea is damaged and keratoconus. Keratoconus is a condition seen in 1 in 2,000 people where the the cornea begins to change shape.
The first ever cornea transplant was performed in 1905, by Eduard Zirm, making it one of the first types of transplant surgery successfully performed. Another pioneer of the operation was Ramon Castroviejo. Soviet eye surgeon Vladimir 's Filatov's attempts at transplanting cornea started with the first try in 1912 and were continued, gradually improving until at 6th of May, 1931 he successfully grafted a patient using corneal tissue from a deceased person.He widely reported of another transplant in 1936, disclosing his technique in full detail.
In 1936, Castroviejo did a first transplantation in an advanced case of keratoconus, achieving significant improvement in patient's vision.
Advances in microscopes enabled surgeons to get a better view of the surgical field, while advances in material science enabled them to use sutures finer than a human hair.
As one would imagine they used large bulky tools at the beginning of this process and it hasn't been until within the last( 20-30 years) that they started making them more efficient. The Instrumental in the success of cornea transplants were the establishment of eye banks. These are organizations located throughout the world to coordinate the distribution of donated corneas to surgeons, as well as providing eyes for research. Some eye banks also distribute other anatomical gifts.
When a patient is need of a cornea transplant, the first thing they do is to put the patients name a waiting list with a the local eye bank. Unlike most other transplant surgeries, the wait for a donated cornea is usually short. After that they measure your damaged cornea and the donors cornea will be custom fit to your eye. There are two types of commonly performed cornea transplant surgeries.
Penetrating keratoplasty is the most commonly performed cornea transplant where the surgeon removes a round piece of the cornea and replaces it with the donated cornea. A newer technique may be used and can lead to faster recovery. Known as lamellar keratoplasty, the inner or outer layer of the cornea is replaced instead of all the layers. Cornea transplants are usually done on an outpatient basis under local anesthesia (the patient is awake) and take about an hour. General anesthesia can be used depending on your age, health and desire to be asleep during the procedure.
How ALK is Performed
With general anesthesia, you will get an injection in the skin around the skin around your eye to control blinking and eye movement during the surgery. Eye drops will then be used to numb the eye. After the doctor gives you anesthesia, the surgeon will remove the central portion of your cornea with a trephine, which is a small circular surgical instrument that works like a cookie cutter. Finally, the donated cornea will be sewn into place with very fine thread. These stitches will remain in your eye until it completely heals, which can be from six months to two years. After the surgery, an eye patch is placed over your eye until the next day when you go in for your follow-up visit with the doctor. After surgery, the patient is usually required to apply eye dro
ps for the next six months.
Technology is used to evaluate the eye before and after surgery. OCT (Optical Coherence Tomography)
scans are performed to evaluate the retina, cornea and anterior chamber of the eye. There is room for growth in health informatics through optic care and cornea transplants to provide even more accurate scanning devices to evaluate the eye. Moreover, with this increase in digital information available, how it will be managed, stored and retrieved must also be considered.
- Corneal Edema
- Corneal Dystrophy
- Chemical Injuries
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