St Thomas Hospital has introduced cutting-edge keyhole cornea transplant procedures that offer minimally invasive, highly effective solutions for patients struggling with severe sight problems secondary to cornea diseases.

The two procedures, known as Descemet Membrane Endothelial Keratoplasty (DMEK) and Deep Anterior Lamellar Keratoplasty (DALK) are the latest innovations to be added to the procedures and services offered at STH Eye Clinic in Qormi, which was officially launched last month.  

St Thomas Hospital is collaborating with Andre Grixti, a leading consultant ophthalmologist and surgeon with extensive experience abroad in the field of cornea transplantation, including in the world-renowned Moorfields Eye Hospital in London, who has been the pioneer in introducing DMEK and DALK to Malta.

“These services are truly a game-changer for patients who require corneal transplants,” Grixti said.

“The precision of these procedures allows us to preserve more of the patient’s natural corneal structure, which not only accelerates recovery but also reduces the risk of complications that are more common with traditional full-thickness corneal transplants.”

He added: “The outcomes we’ve seen with DMEK and DALK are remarkable.  Patients are experiencing not just quicker recoveries, but also a higher quality of vision post-surgery. For many, it’s like turning back the clock to when their vision was at its best.”

The procedures

DMEK represents a significant advancement in the field of corneal transplantation.

Unlike traditional full-thickness cornea transplants, which replace the entire cornea, DMEK involves the selective replacement of only the damaged inner layer of the cornea − the Descemet membrane and its endothelium through a keyhole cornea incision.

This targeted approach results in faster recovery times, a lower incidence of graft rejection and significantly improved visual outcomes.

Patients are experiencing not just quicker recoveries, but also a higher quality of vision post-surgery

In DALK procedures, the patient’s inner corneal layer (the endothelium) is left intact and all other layers of the cornea are removed.

The outer two layers of the cornea (the stroma and epithelium) are removed and replaced with the outer two layers from a donor cornea to give what are known as partial-thickness (lamellar) cornea transplants.

These procedures allow for fewer post-operative complications, less incidence of rejection and shorter use of steroid treatment. 

DMEK and DALK are particularly beneficial for patients whose corneal endothelium has been damaged by inherited conditions, such as Fuchs dystrophy, or as a result of previous eye surgeries, including cataract removal.

By replacing only the inner corneal layer, DMEK minimises the trauma to surrounding healthy tissue, leading to a more natural restoration of vision.

Patient success stories

Judy Kandal, 21, said his vision had dropped to around 60 per cent after he was diagnosed with Keratoconus − a condition which results in the gradual deformity of the cornea. 

He underwent DALK earlier this year and his vision improved drastically. 

“My vision was so clear before but as the years passed, I started noticing my vision was getting blurry,” Kandal said. 

This affected his studies, his work and even his sporting life as a promising athlete. 

“At work I couldn’t see clearly when taking bookings… At football I would see three balls rather than one,” he added. 

“The transplant was a success and I am so thankful. I have my life back.”

Yvonne Cotter, who underwent DMEK at St Thomas Hospital, also shared her experience, saying: “I was astounded by how quickly my vision improved.”

“Within weeks, I could see better than I had in years. The entire procedure was life-changing for me.”

Similarly, Maria Mintoff expressed her relief post-surgery: “I was worried about undergoing eye surgery, but the team at St Thomas made me feel at ease. After the DMEK procedure, my vision has been crystal clear, and my recovery was incredibly smooth. I’m beyond grateful for the care I received.”

For more information about the DMEK and DALK procedures or to schedule a consultation, visit the St Thomas Hospital website.

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