Corneal Transplant

About Corneal Transplant

The cornea is a window of transparent tissue at the front of the eyeball. It allows light to pass into the eye and provides focus so that images can be seen clearly. Various diseases or injuries can make the cornea either cloudy or change shape. This prevents the normal passage of light into the eye and affects vision.
The cornea has three main layers (thin outer and inner layers and a thick middle layer). In some diseases, only the inside layer (endothelium) is affected, causing corneal oedema (swelling) and clouding.

Deep Anterior Lamellar Keratoplasty (DALK)

DALK removes the outer three layers of the cornea and replaces them with donor layers to give a partial-thickness corneal transplant. A Suture is used, which is usually removed a year after the procedure . 90% of patients achieve driving standard of vision however glasses or lenses may be needed or in some cases, another surgery; full recovery may take up to 18 months. There are risks with DALK but serious complications are rare. Astigmatism is common and may need special contact lenses or surgical management after the removal of all sutures .Rejection of the transplanted cornea can also occur but in less than 10% of cases in the 2 years after surgery and it is easy to treat as the rejection does not affect the rear corneal layer (endothelium). DALK generally has a lower risk. However, DALK has a slightly lower chance of achieving 6/6 vision (excellent vision) than with full thickness grafts.

Endothelial Keratoplasty (DSAEK and DMEK)

EK replaces the inside layer of the cornea with a donor layer inserted through a small incision without the need to suture the graft. Most patients achieve driving vision, sometimes with glasses, and it can take up to 6 months to see the full benefits. It is a new type of corneal graft and complications are less serious, these include rejection of the transplanted cornea, graft failure, glaucoma and graft dislocation, which may require the repositioning of the graft by using air or gas, which can be done easily under topical anesthesia. Endothelial Keratoplasty offers faster recovery compared to full-thickness grafts, due to the smaller incision and no suture related problems such as astigmatism, broken suture or inflammation.

Penetrating Keratoplasty (PK)

PK is a full thickness transplant and 75% of patients achieve driving vision, possibly needing vision aids or another surgery, and around 18 months for full improvement of vision. Risks are not common but can be serious and sight threatening including corneal transplant rejection, graft failure, glaucoma, cataract, high astigmatism.

Types of Corneal Transplants

Deep Anterior Lamellar Keratoplasty (DALK)
Endothelial Keratoplasty ( DSAEK and DMEK)
Penetrating Keratoplasty

All the corneal transplant operations are performed under general or local anaesthetic and take about one hour. Patients are examined after surgery and generally go home the same day. They need to use steroid drops for about 1 year, or less for Endothelium Keratoplasty.

Corneal transplant rejection

A corneal transplant can occur due to a rejection or attack by your immune system. This happens in one in six patients in the first two years after transplantation and can cause the failure of the graft. A rejection can often be reversed if anti-rejection medication is started promptly.
Rejection remains a possibility for your lifetime.

Symptoms of rejection are:

Red eye
Sensitivity to light
Visual loss
Pain

A failed transplant can be replaced in a procedure known as a regraft. However, the risk of rejection and failure increases each time a regraft is carried out.

Corneal Transplant Specialists

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Dubai
Abu Dhabi

Dr. Osama Giledi

Consultant Ophthalmologist in Cataract, Cornea and Refractive Vision Correction Surgery

Dr. Osama Giledi is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Osama is skilled in managing ocular surface problems, including severe dry eye and Stem cell deficiency. He performs small incision phacoemulsification for his cataract surgery and is experienced in using toric and multifocal premium intraocular lenses. Dr. Osama’s expertise in managing complex corneal conditions includes all types of modern corneal graft procedures, such as DALK and DSAEK. He has performed over 23,000 refractive surgeries, including Lasik, LASEK, Intralase LASIK and Trans PRK, and phakic IOLs. He delivers the latest treatment for keratoconus, including Intracorneal ring segments, corneal cross-linking and complex laser treatment. Dr. Osama graduated from Libya and completed his ophthalmic training in the UK, attaining a Fellowship in Ophthalmology from The Royal College of Edinburgh in 1996. He completed two years of higher subspecialty training fellowship on the anterior segment, Cornea and refractive surgery in 2003 at the prestigious Corneoplastic Unit and Eye Bank at Queen Victoria Hospital, East Grinstead. He worked as a Consultant Ophthalmologist at the Centre for Sight London and the Corneoplastic Unit and Eye Bank at Queen Victoria Hospital. Dr Osama has 22 years of experience in the UK, providing services for anterior segment, Cornea, Refractive and cataract surgery. In addition to his clinical commitments, Dr. Osama has extensive experience in teaching and training; he is a noted presenter at national and international meetings and has extensive research published in peer-reviewed scientific journals. He is a member of the Royal College Surgeons of Edinburgh, the United Kingdom & Ireland Society of Cataract and Refractive Surgeons, and the European Society of Cataract and Refractive Surgeons.

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Dr. Esmaeil Arbabi

Medical Director and Consultant Ophthalmologist in Corneal transplant, Cataract & Refractive Surgery

Dr. Esmaeil Mohammad Arbabi is a Consultant Ophthalmologist with excellent surgical experience including all types of corneal transplants (DMEK, DSAEK, PDEK, DALK, PKP), ocular surface reconstruction, complex cataract and laser refractive surgery. Prior to joining Moorfields Eye Hospital Center, he was Consultant Ophthalmic Surgeon (Cornea, Cataract & Laser Refractive Surgery) and the Lead for Refractive Services at Royal Liverpool University Hospital, Liverpool, United Kingdom. Dr. Esmaeil holds several prestigious degrees and certifications in the field of cataract and refractive surgery including MSc in Cataract and Refractive Surgery, Certificate in Laser and Refractive Surgery (CertLRS) from Royal College of Ophthalmologist and Fellow of European Board of Ophthalmology Subspecialty Diploma in Cataract and Refractive Surgery (FEBOS-CR). He is a member of Royal College of Ophthalmologists, European Society of Cataract and Refractive Surgeons, European Board of Ophthalmology, UK Cross-Linking Consortium, EYE -LAW CHAMBERS - Medicolegal Expert and Expert, Association of Personal Injury Lawyers (APIL). He is instrumental in high quality papers in various peer reviewed journals and numerous scientific and ophthalmology publications. He is also an examiner for the University of Leeds and the University of Liverpool and for the European Board of Ophthalmologist (FEBO exam).

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