Corneal Transplant (Keratoplasty)
Keratoplasty operations involve replacement of a keratoconic patient’s cornea with a cornea of a deceased person who has agreed to donate his eye or has pledged his eyes.These corneal tissues are thoroughly assessed by various international Eye banks to determine the quality of tissue and to rule out other diseases like Hepatitis, HIV and other infections.
Eye banks ensure that the material does not grow any bacteria and puts them through stringent quality control before releasing the corneas. The diseased cornea is then replaced by a healthy one.
What is the success rate of the keratoplasty operation?
Compared to other transplants in the body, such as lung transplants, liver transplants, bone marrow transplants etc, corneal transplants have the highest success rates because the cornea does not have a blood supply so the chances of rejection are removed. In our experience, corneal transplants are successful for more than 95%. In order to achieve good results, it is essential to get good donor tissue which Laser Eye Centre insists on.
Once the keratoplasty operation has been completed, patients must attend regular follow-up appointments and will need to keep adding special eye-drops to keep the new cornea healthy.
There are two types of keratoplasty operation, the older deep lamellar keratoplasty and the new laser assisted corneal lamellar ablation transplant.
Corneal Lamellar Ablation Transplant (CLAT)
Laser Eye Centre is the first centre in East and Central Africa to offer this new technique. It uses the excellent properties of the 1000htz C-Ten laser to do a fully customised procedure which gives better post operative vision, less chances of rejection and better and faster wound healing.
Advantage of CLAT
Unlike traditional corneal transplants, (PKP), this is non-penetrative, and we retain the original bed of the recipient, replacing only the damaged keratonic cornea, leading to a remote chance of graft rejection and quick recovery. In PKP (Penetrating Keratoplasty), the whole of the cornea is removed and replaced with donor tissue. PKP is done when the endothelium of the cornea has ruptured causing it to become cloudy. This cloudiness is because of the aqueous humor.
Good news for previous corneal transplant patients; with the laser, we can correct irregularities in the cornea to improve vision.
If the corneal transplant has already been done and the patient is not seeing very well, what can be done? If the cornea is clear and there is no rejection and the retina is normal, meaning there is irregular corneal distortion (post corneal transplant astigmatism), what can be done?
The special laser available at Laser Eye Centre can reshape the cornea so that vision can be improved rather than repeating a complete corneal transplant. Dr. Joshi, medical director of Laser Eye Centre, is a pioneer of corneal transplant surgery in East Africa, for more than three decades.
Deep Lamellar Keratoplasty
Deep Lamellar Keratoplasty is where only a partial graft of the cornea (only epithelium and superficial stroma) is removed and replaced by donor tissue this is an older but good technique which is also offered by Laser Eye Centre.
Laser Eye Centre’s Medical Director Dr. Mukesh Joshi is a pioneer of keratoplasty in East Africa and has been performing transplants in Kenya for the last three decades. Laser Eye Centre was also the first centre to carry out Deep Lamellar Keratoplasty as well as being the only centre offering Laser assisted CLAT Keratoplasty.
In conjunction with the Swiss Embassy, the Rotary Club of Nairobi has started a charitable new project where free laser assisted corneal transplants will be done for patients who are not able to afford this treatment, Laser Eye Centre and Dr.Joshi will be offering their services free of charge.