Bahrain participates in Los Angeles Ophthalmic conference
Keratoconus is the commonest indication for cornea transplant in Bahrain
Dr Nada Al Yousuf, consultant Opthalmic, cornea and refractive surgeon at the University Medical Center of King Abdullah Medical City presents a scientific paper on indications of Cornea transplant in Kingdom of Bahrain at the American Society for Cataract and refractive surgery in Los Angeles which is held from 5 to 9 May.
Dr Alyousuf showed in her scientific paper that keratoconus forms the highest indication for cornea transplant forming 41% of total cases. That was followed by corneal edema after cataract surgery which forms 22%, permanent cornea scarring because of old trachoma was 11% followed by microbial cornea infection 10%. Such corneal infections included both with cornea scarring and corneal perforation.
Other indications for cornea transplant in Bahrain according to the study were repeat cornea transplant after previous corneal graft failure which formed 7% and trauma being 4% and viral corneal infections 3% while Fuchs dystrophy was only 1%
Dr Al yousuf mentioned that the cornea is the outermost front part of the eye covering the colored part. It should be transparent and of normal shape for normal vision. She said that disorders leading to cornea transplant either because of corneal scarring leading to loss of the transparency or disorders causing irregular shape of the cornea. The classic example is keratoconus which is progressive thinning and elongation of the cornea causing myopia and astigmatism with deterioration of vision. Glasses usually do not improve vision unless in the early stage of the disease. Hard contact lenses provide reasonable vision. In cases where vision is not improved with contact lenses, then surgical intervention is indicated and cornea transplant is the last resort.
Dr Alyousuf added that one of the preventable indication for cornea transplant is microbial keratitis especially that is related to misuse of contact lens wear whether optical or cosmetic colored contact lenses. All studies worldwide showed that sleeping with contact lenses is the commonest reasons for microbial keratitis. She clarified that microbial keratitis is an infection of the cornea that can be caused by bacteria, fungus or rarely ameba. Patients with keratitis present with severe pain, redness, reduction in vision and increased sensitivity of the eye to light.
.Reasons for keratitis other than contact lens misuse is eye dryness, lid irregularities, reduced immunity, using steroid drops, and corneal abrasions if not treated. Patients with symptoms of keratitis should be seen by an eye doctor urgently and treatment is initiated quickly. In some cases this ends with permanent corneal scarring which is an indication for corneal transplant.
Dr Alyousuf stated that cornea transplant is the most successful organ transplant in the world. This is because the cornea has no blood vessels and therefore is almost hidden from the immune system. She also mentioned that donor corneas are from organ donors after deathwhich are brought from international eye banks. She added that before the surgery, the surgeon makes sure that the cornea is of high quality and screened for all infectious diseases.
The surgery can be done either under local or general anaesthesia and can also be done as a day case. In rare situations, the cornea can be rejected. Symptoms of corneal graft rejection are sudden drop of vision and pain and redness. Patients should see an eye doctor immediately for immediate treatment of rejection which can be reversed.
Dr Alyousuf is one of the prominent speakers at the American Society of cataract and refractive surgery conference. This conference is one of the biggest ophthalmic gathering in the world and is held yearly in the United States of America. It includes keynotes lectures, free paper presentations, skills lab workshops and live eye surgeries.