Corneal Grafts & Transplants
What is the cornea?
The cornea is the front most part of the eye. It is a clear dome shaped structure around half a millimeter thick. It is responsible for around two thirds of the focusing power of the eye. The function of the cornea can be reduced by trauma, infections, inflammation, keratoconus and corneal dystrophies.
For diseases of the cornea there are optical, medical, laser and surgical treatments available to help improve your symptoms or eyesight.
What is a corneal graft?
When the cornea can no longer function properly, corneal surgery (keratoplasty) may be required. As a subspecialist corneal surgeon, Dr Gunn is internationally trained in performing the full range of modern corneal graft techniques.
What are the different types of corneal graft?
A full thickness corneal graft is called a penetrating keratoplasty. This procedure involves removal of the entire thickness of your cornea and replacing it with a full thickness donor graft. This is the classical corneal transplant. It is required in some cases, though has been superseded in a number of diseases where only certain layers of the cornea are diseased and are selectively replaced.
Deep Anterior Lamellar Keratoplasty
This procedure is used for diseases in the front of the cornea. It involves replacement of the front 95% of the cornea and is useful in keratoconus and corneal scars. It has the benefit of lower rates of graft rejection and higher strength.
This procedure is used for diseases of the back of the cornea such as Fuchs Endothelial Dystrophy. Dr Gunn is specially trained and experienced in the newer DMEK surgery (Descemets Membrane Endothelial Keratoplasty) as well as DSEK and DSAEK surgeries and performs these in his Brisbane surgery. DMEK has shown to give better quality of vision and faster recovery of vision compared to the older techniques. In this surgery, only the very back layer of the cornea is transplanted – 100 micrometers (0.1mm) for DSAEK and 12 micrometers (0.012mm) for DMEK. These grafts are held in place with air bubble.
How long will it take to recover from my cornea graft surgery?
Plan to take a week off work. You should avoid heavy lifting or swimming for one month. You will need to take antibiotic and steroid drops following surgery. For DMEK or DSAEK surgery you should plan not to fly for 1 – 2 weeks as there will be air inside your eye. Following surgery you will need to lie on your back for two days to help the graft take.
What if I am uninsured?
Dr Gunn is pleased to offer intermediate corneal graft surgery through the Mater hospital Brisbane. You will be seen before and after surgery at the Queensland Eye Institute.