A corneal transplant is a surgical procedure which involves removing all or part of a patient’s diseased or damaged cornea and replacing it with healthy corneal tissue from a donor. The cornea is the clear element at the front of the human eye, which refracts incoming light as it passes through to the inner eye. When the cornea becomes misshapen, cloudy, scarred or otherwise damaged, the vision and comfort of the eye can be affected. An ophthalmologist resorts to a corneal transplant when other methods of treatment have been exhausted. The corneal transplant is the most commonly performed, and most successful, of all transplant surgeries.
Reasons for considering a corneal transplant:
- Complications from other eye surgery resulting in failure and swelling of the cornea.
- Dystrophy of the cornea.
- Eye trauma resulting in corneal scarring.
- Hereditary problems with the cornea such as Fuchs’ corneal dystrophy.
- Keratoconus, a disease in which the cornea degenerates into a steep cone shape.
- Rejection of a previous corneal transplant.
- Various corneal infections that lead to scarring, including herpes viruses.
Doctors usually prefer to exhaust other non-invasive forms of treatment first. However, when problems of vision and/or discomfort can no longer be treated with glasses, contacts, pharmaceuticals or other specialized treatments, corneal transplant surgery is a viable solution.
Depending on your condition, your doctor may recommend one of the variety of partial thickness transplants; Descemet’s Membrane Endothelial Keratoplasty (DMEK), Descemet’s Stripping Automated Endothelial Keratoplasty, (DSAEK), Deep Anterior Lamellar Keratoplasty (DALK) or a full thickness corneal transplant. Once the decision is made to undergo corneal transplant surgery, a suitable donor cornea must be obtained through an eye bank. Each potential donor is carefully screened, for diseases that could be transmitted and for clarity. The surgery is usually an outpatient procedure. The doctor may choose either a local or general anesthetic, whichever is most appropriate for the patient.
Once the donor cornea is placed, it is sutured with extremely thin stitching, although some of the partial thickness transplants are initially held in place with air or gas. The doctor administers antibiotic eye drops, then places a patch and protective shield over the eye.
The patient is advised to rest the day of the surgery. There will be a post-operative appointment with the doctor the next day. After this, the patient may resume gentle tasks and activities, but must wear glasses or a shield to protect the eye, and administer eye drops as instructed by the physician. After a week, more strenuous activities (like exercise) may be carefully resumed. Stitches may be left in the eye anywhere from a few months to a year, or longer. The patient must remain vigilant for signs of complications, and contact the eye doctor immediately upon any abnormal occurrence.