Corneal Transplant Essay

Da Eun Kim

March. 28th. 2011

An organ is a part of an organism that is typically self-contained and has a specific vital function.

There are lots of different organs in our body and they are all very significant. However, if one of organ

fails, it needs to be replaced by new healthy organ. This process is called organ transplant. There are

many types of organ transplants such as kidney, liver, heart, lung and cornea transplant. In this essay, I

will talk about corneal transplant. The first successful corneal transplant was performed in Olomouc,

Moravia, (Czech Republic) on 7 December 1905 and it is very beneficial process. (NHSBT, 2009) I will

discuss the function of cornea, why people need corneal transplant, the process of transplant, benefits

and limitation, social issue and economic issue.

Figure 1: Diagram of cornea (NEI Health Information, 2011)

A cornea has several functions. The cornea is the clear front tissue the colored iris and the round

pupil. It is made up of proteins. It also serves light to enter the eye and it focus on the retina. The cornea

keeps our vision clear for us to be able to see clearly. It means that if it get injured or damaged, it may

become cloudy and blurry and people will get long and short sightedness. These problems make it very

difficult for people to see normal things such as reading or note taking. People may need a corneal

transplant to bring back their vision.

Why do people need a corneal transplant? There are 4 main reasons - corneal edema, corneal

dystrophy, Keratoconus and other disorders. Corneal edema is sometimes called as swelling and it can

sometimes occur after cataract sugary or due to diseases. The swelling can cause foggy vision and if it

advances, people can feel very painful. In some cases, it can be treated with eye drops or ointment but

other is necessary to transplant new cornea. Corneal dystrophy is the problem with normal cell growth

in part of the eye. These diseases have many features:

They are usually inherited.

They affect the right and left eyes equally.

They are not caused by factors such as injury, activity or diet.

They are not usually related to other diseases in the body, nor do they generally affect

other parts of the body.

Most occur in people (both men and women) who are otherwise totally healthy.

Keratoconus is the process of the cornea becoming thinner and forming into odd shape. The middle part

thins and bulges outward in rounded cone shape. This abnormal curve will make vision blurry. It often

happens in patients who are teenager or in mid-twenties. It can be corrected with glasses or contact

lenses in the beginning stage but if the vision becomes misshaped, corneal transplant is necessary.

(Casey Eye Institute, 2005) Other disorders are the most common reason for corneal transplant and the

examples are chemical injuries, accidents, lacerations and infections.

The corneal transplant happens in many steps. If people need corneal transplant, they will need

to find someone to donate cornea or be put one a cornea recipient list. In many cases, a donor cornea is

acceptable within a week or two. The operation can be carried out either under local or general

anesthetic. The doctor uses equipment that holds the eye open, and then remove the damaged cornea

and replacing it with new healthy cornea of exactly same size and shape. This whole process commonly

takes an hour or two. After the operation, people will stay in hospital for one or two days. The operated

eye may be covered with an eye pad and a plastic eye shield, which can be removed the day after

operation. The vision will be blurry after the pad is removed but it's normal. The eye may be little bit

watery and sensitive to light and eye drops will be provided to use for until it heals completely. The

drops will help to lower people's body will reject the transplant. It may be significant to have either

spectacles or contact lenses to obtain the best vision from transplant.

Figure 2: Process of corneal transplant

(allrefer, 2008)

Corneal transplant includes lots of benefits. To begin with, the corneal transplant offers faster

recovery times. Mostly, after surgery, people can leave the hospital in about 2 or 3 days. Although the

patients need some cares when they come back their home, it still provides fastest recovery times than

other organ transplants. Secondly, success of corneal transplant rate is higher than other organ

transplant. For example, corneal transplants are successful sight-saving operations, with 93% of

transplants functioning after one year. By five years, 74% of transplants are still functioning and many

will continue for many more years after that. (NHSBT, 2009) Lastly, people can recover perfect eye

vision. Even though patients had worse eyesight than before, they can recover their vision better than

before.

Figure 3: Before corneal transplant and after (allrefer, 2008)

Corneal transplant also has several limitations. Firstly, there is rejection of cornea. It happens in

5 - 30 per cent of patients and is more frequent in the first year after the transplant. (Papalois, 2009) The

sign of rejection is RSVP-Redness, Sensitivity, Vision and Pain. Surprisingly, one third of our patients who

were rejecting their transplant didn’t even realize it – it was found during a routine follow up exam.

Second limitation of corneal transplant is that pressure increase within the eyeball (glaucoma).

Furthermore, there are lots of complications such as eye infection, cataracts (increased risk of clouding

of the eye's lens), problems with the stitches used to secure the donor cornea, and swelling of the

cornea.

The cornea transplant could affect on the society. Nowadays organ donors are very rare and

even if the patients get ready to transplants, sometimes we can't find the cornea for transplanting. If

someone needs a cornea to transplant but it is lack, he might consider about organ trafficking. It is very

serious problem in society and also to the people. For example, there is a shortage each year of

approximately 500 corneas. The number of requests to NHSBT that cannot be met has increased owing

to increased demand. And last year, 2,075 people donated their eyes after their death but there is still a

major shortage of corneas in the UK. (NHSBT, 2009)

The corneal transplant has an economical issue. The cornea transplant is a very expensive

surgery. People need to pay $7,500-10,000 to have cornea transplant surgery and this expensive price

can be the problem of economic issue. Because of the costs, poor people couldn't have cornea

transplant and they may refer to crimes to get a donor or to have the transplant. For example, a poor

man is charged with stealing two human corneas that were donated to transplant other people. He stole

it because he didn’t have enough money to undergo corneal transplant surgery. Police said they had

been stolen from a bus station in Boston.

In conclusion, corneal transplant is very interesting process. This essay talked about cornea,

process of corneal transplant, advantages and limitation and two one-world issues. It has more

advantages than disadvantages and it is rated the highest succeeded transplant. If the corneal transplant

keeps advancing and to be researched more, it would save lots of people's vision. People need to

prevent organ trafficking and try hard on it. Also, there should be more donors corneal so the cost could

be lower as well.

Works Cited

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