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Benefits of emergency corneal graft surgery analysed in six-year research study

Posted: 16/05/2017

A study into the benefits of corneal graft surgery has concluded that the outcomes for most patients are good, retaining useful eyesight despite often horrific injuries.

The cornea is the clear outer layer at the front of the eye that forms a ‘window’, through which the iris and pupil can be seen. Its function is to help focus light on the photo-sensitive cells of the retina, in turn enabling the brain to process images. If it becomes damaged then the light transmitted to the retina is distorted and the image becomes unclear.

Corneal graft surgery is one of the most common types of transplant performed. All or part of a damaged cornea is surgically replaced in a procedure known as keratoplasty, which aims to improve sight and alleviate pain. There are different forms of keratoplasty depending on the degree of corneal damage.

One of the most common reasons for keratoplasty is a condition called keratoconus in which the cornea changes shape, affecting the distribution of light to the retina and distorting vision. Other common causes include infection, ulcerative keratitis and a range of diseases. Often, treatment can be planned and is routine, but sometimes it is needed as an emergency, for example in an eye that is perforated as a result of an accident or aggressive infection.

There has been relatively little investigation of the effectiveness of emergency corneal grafting, but this latest study analyses data over a six year period in the UK. The results, published in the British Journal of Ophthalmology, identified almost 13,000 cases of corneal grafting, of which 1,330 involved emergency transplant or re-graft. Just under 70% of patients had good functional vision post-operatively; around 30% were able to see well enough to count fingers; with around 9% reporting their vision had deteriorated.

Andrew Clayton, a senior associate in Penningtons Manches’ clinical negligence team, comments: “Relatively little has been published on the benefits of emergency corneal graft surgery to date and while expert evidence indicates that the patient outcome is likely to be good, it is helpful to have objective, independent research to support this. Proving that emergency surgery would have made a difference where patients allege delay is important if a claim is to succeed.

“Patients who do not have timely surgery face a difficult future, where the loss of vision can have devastating consequences on work, family and social lives. There is an underlying problem in the shortage of corneal donors in the UK. Many more patients would benefit from a greater number of donors and we would encourage people to make their wishes clear where they are happy to donate their corneas to others.”

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