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The human corneal transplantation (keratoplasty) had been attempted with little or no success throughout the 1800s using both animal donor cornea and human graft tissue. The donor tissue, whether animal or human, could either be transplanted as a full-thickness disc of cornea or partial-thickness (layers or lamellae) cornea attached to the host ...
This relatively new procedure has revolutionized treatment of disorders of the innermost layer of the cornea (endothelium). Unlike a full-thickness corneal transplant, the surgery can be performed with one or no sutures. Patients may recover functional vision in days to weeks, as opposed to up to a year with full thickness transplants.
Depending on the type of keratoprosthesis used, the surgery may involve a full thickness replacement of the cornea or the placement of an intralamellar implant. For the Alphacor a manual incision is used to create a corneal pocket and a punch is used to create an opening through the posterior cornea into the anterior chamber.
In 1905, when Eduard Konrad Zirm, MD, performed the first successful full thickness corneal transplant, [4] a long line of corneal transplantation, research and techniques began. During its existence, Zirm's eye bank, located in a rural area of Austria, treated over 47,000 patients.
Autologous full-thickness grafts involving transplantation of the entire epidermis and dermis to provide better cosmetic outcomes can be used for smaller wounds. [19] As for larger wounds, autologous split-thickness grafts involving transplantation of the epidermis and partial portion of the dermis are used. [19]
PDEK is different from the whole cornea transplantation in which the transplantation of entire donor cornea to the recipient is done. [2] [3] Normal corneal thickness is about 520 to 540 microns in the centre and 600 to 620 microns in the periphery. [4] Pre descemet's layer which is dissected in PDEK, measures about 10.15±3.6 microns thick. [5]
Historically, penetrating keratoplasty, or full thickness corneal transplantation, was the treatment of choice for irreversible endothelial failure. More recently, new corneal transplant techniques have been developed to enable more selective replacement of the diseased corneal endothelium.
Penetrating keratoplasty: It is the traditional full thickness corneal transplant procedure, in which trephine (a circular cutting device) is used to cut opaque cornea, a similar-sized portion of the donor cornea is removed with a second trephine. The removed part of donor cornea is known as corneal button. The donor tissue is then sutured to ...