What Is a Corneal Transplant?
A corneal transplant, or keratoplasty, is a surgery that replaces part of the cornea, the clear, curved portion of the eye, with tissue from a donor. This procedure is performed when the cornea is diseased, injured or irreparably damaged and unable to focus light correctly into the eye. Although in some cases the transplanted tissue can be rejected, most corneal transplants are successful.
Corneal eye disease is a common cause of blindness, accounting for more than 5% of the cases of blindness in the world.
When Is a Corneal Transplant Needed?
The following conditions may necessitate a corneal transplant:
- Keratoconus, a condition that makes the cornea bulge, and can lead to vision loss
- Corneal scarring, from eye infections such as eye herpes or a fungal infection
- Fuch’s dystrophy, an inherited corneal disease
- Corneal injury from chemical burns or trauma
- Corneal edema, caused by swelling of the cornea
- Scars from trichiasis – when the eyelashes grow inward and scratch the cornea
- Corneal damage – from LASIK or cataract surgery
Almost 50,000 cornea transplants are performed in the United States each year, according to the Eye Bank Association of America. Since the 1960s, more than one million people have had their sight restored with a corneal transplant.
Corneal Transplant Procedures
Corneal transplants use tissue from a donor. This tissue is stored frozen and then obtained from an eye bank. A patient may need to wait for a period of time until a suitable cornea is available.
While there are several types of keratoplasty procedures, traditional corneal transplant surgery and endothelial keratoplasty are the most common.
Traditional Corneal Transplant
Another name for this type of surgery is penetrating keratoplasty or PK. A button-shaped portion of diseased corneal tissue is removed with either a cutting instrument called a trephine or a femtosecond laser. The eye surgeon removes a piece of tissue from the donor cornea and does the same on the patient's cornea, then surgically places the donor tissue into the patient's cornea and sutures it in place. These stitches remain for more than a year.
Penetrating keratoplasty is performed in an outpatient setting and the patient can be driven home after surgery.
Endothelial Keratoplasty
This procedure has been developed in the past decade, and removes only the innermost part of the damaged cornea, the endothelium, but leaves the outer tissue of the patient's cornea intact. This surgical procedure is performed when the problem is with the patient's endothelium, which regulates fluid in the cornea. When the endothelium malfunctions, corneal swelling and vision loss can result.
During endothelial keratoplasty, the surgeon makes a small surgical incision on the eye and places a healthy section of the endothelial layer from the donor into the back surface of the patient’s cornea. The surgeon will create a small air bubble to keep the new tissue in place, and the incision will heal on its own without stitches.
What Patients Are Saying
Recovery from Corneal Transplant
It may take as long as a year to fully recover from a corneal transplant, and vision is likely to be blurry the first few months after surgery. However, patients can often return to work after a week. Strenuous exercise and heavy lifting are not recommended during the first few weeks of recovery. Your eye surgeon will provide a comprehensive guide to optimize your recovery and what to expect afterwards.
As with any eye surgery, it is vital to follow the instructions of your eye surgeon to minimize corneal transplant complications and help your eye to heal.
Your eye doctor will prescribe steroid eye drops after surgery to hasten the healing process as well as other medications that can fight inflammation and prevent infections. For the first few days the patient is instructed to wear an eye patch.
In the ensuing weeks, the patient should protect their eyes from harmful UV rays with sunglasses and beware of anything bumping into their eye area. If stitches were used, the eye surgeon will usually remove or adjust them anywhere between 3 to 18 months after surgery.
If you have corneal damage and want to learn more about corneal transplants, schedule an eye exam with Opthalmology Doctor Name at Opthalmology Practice Name in LOCATION1 to find out which treatment option is best for you.
