A brief explanation of corneal transplantation

  Corneal transplantation is the removal of diseased cloudy corneas and transplantation with clear allograft corneas to restore the patient’s vision; or the removal of necrotic and inflammatory lesions to treat certain corneal inflammatory conditions to control infection and preserve the eye. Depending on the treatment and purpose, they can be divided into penetrating corneal transplantation and lamellar corneal transplantation.  A lamellar corneal graft is a partial thickness corneal graft in which the diseased tissue in front of the cornea is removed during surgery, leaving the underlying tissue as the graft bed, which is usually very thin, even leaving only the posterior elastic and endothelial layers. Therefore, lamellar corneal transplantation is feasible for all corneal lesions that do not invade the deep corneal stroma or the posterior elastic layer, and where the endothelium is healthy or recoverable. It is commonly used in eyes with superficial corneal opacity or corneal dystrophy, progressive keratitis or ulceration, corneal fistula, corneal tumor, and some eyes with poor conditions that cannot undergo penetrating corneal transplantation.  In contrast, penetrating keratoplasty is a method of replacing a full layer of cloudy cornea with a full layer of clear cornea. Common indications are conical cornea, corneal scarring from various causes, corneal dystrophy and corneal endothelial cell failure.  Modern corneal transplantation also includes posterior lamellar corneal transplantation and corneal endothelial transplantation, mainly for those with corneal endothelial loss without stromal layer lesions, such as large vesicular keratopathy, corneal endothelial dystrophy, etc.  Corneal limbal stem cell transplantation includes autologous transplantation, allogeneic transplantation and cultured cell transplantation. For patients with severe corneal limbal stem cell injury or deficiency, corneal limbal stem cell transplantation must be performed successfully before corneal transplantation can be performed, otherwise it will fail.