Cornea transplant

Content

Introduction

The cornea is the transparent tissue that makes up the front of the eye. Its function is to let the light pass, thus allowing the images to be imprinted on the retina. When the cornea is damaged due to accidents or diseases, it loses its transparency, images no longer appear clear and vision is impaired.

Corneal transplantation is a microsurgery operation performed with the help of an operating microscope. It consists in replacing the central portion of the cornea with a corneal flap taken from selected donors. The operation takes place under general or local anesthesia and, usually, it does not require a compatibility between the donor and the recipient.The success of the transplant is identified with the possibility of restoring the ability to see to the operated eye.

When it is necessary

There are several cases in which a cornea transplant is required:

  • diseases present at birth (congenital)
  • trauma due to accidents
  • outcomes of infections, which make the cornea opaque or deformed and which progressively damage vision

Diseases of the cornea, in most cases, affect both eyes, making people almost completely blind (young people between the ages of 15 and 35 are most affected by these diseases). There is no age limit for cornea transplantation, the operation can be performed in both young and old people and offers them the opportunity to regain their sight, returning to a normal life.

Origin of the corneas used for transplantation

Transplantation requires a healthy cornea from a dead donor.All people between the ages of 4 and 79 are potential donors. They can also donate people with vision problems, such as myopia or cataracts. Each potential donor is evaluated to exclude the presence of communicable diseases and ensure safety corneas taken.

The main exclusion criteria are:

  • some infectious diseases, for example, AIDS, hepatitis B and hepatitis C, active tuberculosis, Creutzfeldt-Jacob disease, multiple sclerosis, ALS, Alzheimer's disease, and Parkinson's disease
  • previous organ transplant
  • some eye diseases

All possible risks are taken into consideration by the doctor responsible for assessing the final suitability of a potential cornea donor.

How is the selection of corneas

After collection, the donated corneas are sent to one Bank of the Eyes, a public or non-profit health facility that has the task of collecting, selecting, storing and distributing tissues suitable for transplantation, certifying their quality and safety.

In Italy there are 13 authorized ocular tissue banks. Each bank is periodically inspected by the National Transplant Center together with the Regional Transplant Center to verify that it operates in compliance with the regulations.

Inside the bank laboratory, the fabric is also prepared by working it according to the type of transplant it was intended for. It is then stored at + 4 ° C (short-term cold storage, up to about 10 days) or at + 4 ° C. 31 ° C (in culture, up to 30 days).

To be transplanted, corneas must be analyzed by evaluating the viability of their cells and some biological parameters.

In order to ensure maximum safety for the recipient of the cornea, the donor's state of health is also carefully re-evaluated.

After being analyzed, prepared and stored in the bank, the corneas deemed suitable are sent to the health facilities that require them to be transplanted. Corneas deemed unsuitable can be used, if consent has been obtained, for research into innovative conservation, bank processing and transplant techniques.

Italy is one of the European countries with the largest numbers of donated and transplanted corneal tissues. Thanks to them, it can usually respond to all transplant requests.

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