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Corneal Transplant

Definition

Corneal transplant is a surgical procedure used to replace a portion of a diseased or damaged cornea with a healthy one. The cornea is the clear, outer surface on the front of the eye.

Cornea of the Eye
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Reasons for Procedure

A corneal transplant can correct vision problems caused by infections, injuries, or medical conditions that effect the cornea. It is often recommended for the following:

  • Keratoconus—a thinning and bulging of the cornea that causes blurred vision
  • A cornea scarred from infection or injury
  • Clouding of the cornea
  • Complications of previous eye surgery

Possible Complications

The procedure is highly successful. Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Rejection of the new cornea—The body’s defense system attacks the new tissue, damaging it.
  • Glaucoma
  • Problems focusing
  • Swelling or detachment of the retina
  • Cataract
  • Infection
  • Bleeding

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

The operation is most successful for patients who have the following:

  • Keratoconus
  • Corneal scars

It is less successful for those who have corneal infection and severe injury, like a chemical burn.

What to Expect

Prior to Procedure

Your ophthalmologist may do a physical exam and blood tests.

Before the procedure:

  • Talk to your doctor about your medications. Also, discuss any herbs or vitamins you take. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets
  • Arrange to have someone drive you home.
  • Arrange for help at home after the procedure.
  • Use any eye drops as instructed by your eye surgeon.
  • The day before, do not eat or drink anything after midnight unless told otherwise by your doctor.

Anesthesia

Two types of anesthesia can be used during a corneal transplant:

  • Local anesthesia to numb the eye—You will stay awake.
  • General anesthesia —You will be asleep.

Description of Procedure

The procedure will be done under a surgical microscope. The damaged part of the cornea will be cut out. The new cornea will then be placed in the opening. The new cornea will be fastened with very fine stitches. Finally, a patch and shield will be put over the eye.

There is another technique called Descemet's stripping endothelial keratoplasty (DSEK). DSEK is used for some types of cornea transplants. It may result in shorter recovery time and better vision. With this technique, the doctor removes a much smaller part of the cornea, compared with older procedures.

How Long Will It Take?

1-2 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

You will most likely go home after a few hours in the recovery area.

Post-procedure Care

At Home

After you leave the hospital, you should rest for the remainder of the day. When you return home after the procedure, do the following to help ensure a smooth recovery:

After you leave the hospital, you should rest for the remainder of the day. When you return home after the procedure, do the following to help ensure a smooth recovery:

  • Continue to wear the eye patch until your doctor instructs you to remove it.
  • Use eye drops as prescribed.
  • Wear glasses during the day, and wear a shield to protect your eye at night.
  • Protect your eye from accidental bumps or pokes.
  • Do not rub or press on your eye.
  • Do not swim until allowed by your doctor.
  • Avoid contact sports.
  • Do not drive until your doctor gives you permission.

Your eye will be checked several times during the following weeks and months. Stitches are usually left in place for at least several months.

Vision may initially be worse than before your surgery before your eye adjusts to the new cornea. It may take several months for it to improve.

Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Vision symptoms, including decreased vision, floaters, flashing lights, increased light sensitivity, or loss of peripheral vision
  • Increased eye redness
  • Increased pain
  • Persistent nausea or vomiting

If you think you have an emergency, call for medical help right away.

Revision Information

  • Eye Bank Association of America

    http://www.restoresight.org

  • The National Keratoconus Foundation

    http://www.nkcf.org

  • The Canadian National Institute for the Blind

    http://www.cnib.ca

  • Canadian Ophthalmological Society

    http://www.eyesite.ca

  • Corneal surgery. The University of Mississippi Medical Center Department of Ophthalmology Services website. Available at: http://www.umc.edu/education/schools/medicine/clinical%5Fscience/ophthalmology/clinical%5Fservices(ophthalmology)/corneal%5Fsurgery%5Ffaq.aspx. Accessed June 27, 2013.

  • Corneal transplants. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/corneal%5Ftransplantation/eye%5Foverview.aspx. Accessed June 27, 2013.

  • Corneal transplants. National Keratoconus Foundation website. Available at: http://www.nkcf.org/corneal-transplants. Accessed June 27, 2013.

  • Facts about the cornea and corneal disease. The National Eye Institute at the National Institutes of Health website. Available at: http://www.nei.nih.gov/health/cornealdisease/index.asp. Updated May 2013. Accessed June 27, 2013.

  • Frequently asked questions. Eye Bank Association of America website. Available at: http://www.restoresight.org/about-us/frequently-asked-questions/. Accessed June 27, 2013.

  • New advance in cornea transplantation. Duke Health website. Available at: http://www.dukehealth.org/eye%5Fcenter/health%5Flibrary/news/new%5Fadvance%5Fin%5Fcornea%5Ftransplantation. Updated July 10, 2009. Accessed June 27, 2013.