Cornea Transplant
What is the cornea?
The cornea is the transparent surface of your eye; it is generally dome shaped and accounts for most of your eye’s focusing power.
What is a corneal transplant?
A corneal transplant (“keratoplasty”) is a surgical procedure where part of the cornea is replaced with a donor’s corneal tissue.
A corneal transplant has been known to restore vision, enhance the look of a damaged or diseased cornea, and reduce pain in the cornea.
Is a corneal transplant right for me?
If you answer “Yes” to any of these questions, you may be a candidate for corneal transplants.
- Do you have a thin or cloudy cornea?
- Do you have corneal ulcers?
- Are you experiencing corneal scarring (caused either from injury or infection)?
- Does your cornea bulge outward (Keratoconus)?
- Are you experiencing complications from a previous eye surgery?
What is it like to have corneal transplant surgery?
Before Surgery
Before your corneal transplant a number of things will occur. First, your doctor will give you a complete preoperative examination and will make every attempt to confirm optic nerve and retinal function prior to surgery. This can help to avoid cases in which visual improvement does not occur. Your doctor will also take specific measurements of your eye to determine what size cornea you will need from a donor.
You’ll be given a sedative to help you relax and a local anesthetic to numb your eyes. Children and anxious patients might require general anesthesia.
During Surgery
During the corneal transplant, your doctor will cut through the diseased or abnormal cornea to remove the corneal “button”; this is a disc of corneal tissue. A tool called a trephine, which looks like a cookie-cutter, is used to make the cut.
At this point, the donor tissue has been processed and is tested extensively to ensure that it is healthy and an ideal cornea for transplantation. It has also been cut to fit on the patient’s eye bed.
Once the bed is ready for the donor cornea, the donor cornea is gently set and sewn into its place with a very fine thread. The sutures remain intact for up to a year. Your doctor may remove them periodically at future visits.
After Surgery
Following Corneal Transplant surgery:
- You will receive several medications such as eye drops and sometimes oral medications. These help to control infection, pain, and swelling.
- You will wear a protective eye shield. The metal eye shield helps to protect your eye. You’ll wear the eye shield for a day or two immediately after surgery and then only at night for the next few days following surgery.
- You must protect your eyes from injury.
The first year after surgery you should expect to have frequent eye exams. Usually these exams are weekly at first and these are followed by monthly exams. Eventually you may be able to see your doctor only every few months.
Frequently Asked Questions
What are the possible complications of a corneal transplant?
Most corneal transplants are successful, though, as with any surgical procedure, there is a small risk of complications. The most common complication is rejection of the donor cornea. Some other possible complications include:
- Cataracts
- Swelling of the cornea
- Infection of the eye
- Problems with the stitches that are used to transplant the donor cornea
- Glaucoma
- Corneal rejection
What is corneal rejection?
Corneal rejection occurs when the patient’s immune system attacks the cornea from the donor. This can require additional treatment or sometimes another corneal transplant. Patients who have had a corneal transplant should report to their doctor any signs of rejection, including:
- Pain
- Redness
- Light sensitivity
- Loss of vision
Corneal transplant rejection occurs in about 10% of cornea transplants. Therefore, it is not uncommon and patients should be aware of the symptoms of corneal transplant rejection.
What are common corneal conditions that we treat?
Some corneal conditions that require treatment include dry eye, keratoconus, pterygium, viral infections, trauma, recurrent corneal erosions, and corneal dystrophies such as Fuchs’ endothelial corneal dystrophy and epithelial basement membrane disease.
What are common corneal treatments?
Most corneal conditions can be treated medically with eye drops, ointments, pills, contact lenses, amniotic membranes, etc. On occasion, office procedures or surgery may be recommended to help improve your symptoms. Office procedures include the insertion of punctal plugs for dry eye or a corneal debridement with anterior stromal puncture for epithelial basement membrane disease. Surgeries include corneal transplant surgery or pterygium surgery.
