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Keratoplasty :
Penetrating Keratoplasty (PK):
→ Full thickness Keratoplasty
→All 5 layers taken from donor
Lamellar keratoplasty (LK):
→ Partial thickness Keratoplasty
→ Only outer layers taken from donor
Recipient retains his own:
1.Endothelium
2.Descement’s membrane
3. Stroma +/ -
→ Donor provides his:
1.Endothelium
2.Descement’s membrane
3. Stroma +/ Corneal Transplant:
→ Corneal transplant is the most successful organ transplant in the body (because Cornea is Avascular)
→ Lamellar Keratoplasty is more successful than Penetrating Keratoplasty
→ Maximum rejection is from Endothelium***
→ Lamellar Keratoplasty is technically more demanding.
Penetrating Keratoplasty:
Indications:
1.Pseudophakic bullous Keratopathy [PBK] - (Most common worldwide)***
2. Non healing ulcer
3. Corneal scar - (Most common indication in India)***
4. Corneal Dystrophy
5. Keratoconus - (Most common indication in America)***
6. Chemical injuries
Corneal Donations :
→ Live person cannot donate.
→ “Pledge” the cornea → consent signed for corneal donation.
→ Only 60,000 corneas are collected in India last year.
→ India requires 3 - 3.5 lakh corneas
→ Inform spouse before pledging cornea.
→ HLA matching not required
→ To be donated within 6 hours after death
→ Preserved in MK (mc Carey Kaufmann) media (preserves for 96 hours)
Contraindications :
1. HIV
2. Hepatitis B
3. Septicemia
4. Rabies
5. Prions
6. Retinoblasts
7. Metastatic brain tumor
8. Leukemia's
9. Lymphomas
10. Head and neck cancers.