Corneal transplant procedure

The corneal transplant was the very first successful human transplant. It is now performed more frequently worldwide than all other organ transplants combined and is unbeaten with a success rate of over 90%.

There are different transplant procedures depending on the individual illness. On the one hand, a perforating keratoplasty, in which all layers of the cornea are transplanted, or only part of the donor cornea is transplanted (lamellar technique).

Mrs. Serena Brabänder at the workbench in the clean room
Mr Marvin Schwarz
Mrs. Serena Brabänder with a cornea
Mrs. Katja Schulz counting Edothel cells

Perforating keratoplasty

With perforating keratoplasty, the entire thickness of the cornea, i.e. the epithelium, stroma and endothelium, is replaced. Your own, diseased or cloudy cornea is removed and a new donor cornea is inserted. The excretion of both your own and the donor corneas to the correct size is usually done with the help of the excimer laser. The new horn skin is then sewn in with two continuous sutures ("star") or with single sewn sutures, which are normally pulled for 12 and 18 months.

This type of surgery is typically performed under general anesthesia.

DMEK

With DMEK (Descemet Membrane Endothelial Keratoplasty) only the innermost layer of the cornea, the endothelium, is replaced. This layer is responsible for maintaining homeostasis and the transparency of the cornea. The donor tissue is fixed using gas, which presses the new donor tissue against the stroma. For this, a strict supine position is necessary after the operation.

This surgical technique is possible in retrobulbar or even drip anesthesia.

DALK

In a DALK (Deep Anterior Lamellar Keratoplasty), the epithelium and the anterior stroma, i.e. the top two layers of the cornea, are replaced while the endothelium, the innermost layer, remains. As with perforating keratoplasty, the donor cornea is fixed with sutures.