The cornea is a clear, dome-shaped structure that covers the front of the eye. It is a vital structure as it plays a central role in focusing your vision. Unfortunately, the tissue is relatively fragile and can break down, either as a natural result of the aging process or from trauma, and make focusing nearly impossible. A corneal transplant, formally known as keratoplasty, is a surgical procedure in which all or part of the cornea is replaced with healthy tissue from a donor. If successful, the procedure has the potential to restore vision loss driven by corneal defects, improve the appearance of your eye, and reduce or eliminate pain.
A corneal transplant is used to treat a wide range of conditions, including but not limited to a bulging, thinning, scarred, or swollen cornea; corneal ulcers; and Fuchs’ dystrophy. As is the case with any surgical procedure, there are risks to be aware of before electing to undergo the procedure. Your Center for Sight surgeon with discuss the complications and risks with you prior to the procedure.
What to Expect
Prior to a corneal transplant, you will need to go through a comprehensive medical exam to ensure you can benefit from and are healthy enough to undergo the procedure. You will also discuss all of the medications and supplements you are currently taking, and which ones you may need to discontinue before the day of surgery. Your physician will also assess any comorbidities that you have which could cause complications during or after the procedure, and take detailed measurements of your eye to determine exactly what size donor cornea you need.
Before the procedure begins, you will typically be given a sedative to help you relax and a local anesthetic will be injected into the eye to prevent you from feeling pain or discomfort. The most common type of corneal transplant is called penetrating keratoplasty, during which your physician will cut a hole through the abnormal part of the cornea and remove a disk of tissue. They will then cut the donor cornea to size and place it in this new opening and stitch it to the rest of your natural cornea to hold it into place. This entire process will take between one and two hours and, thanks to the local anesthetic, you should not feel any pain.
Some patients, for whom only certain layers of the cornea need to be replaced, undergo an endothelial keratoplasty. In this procedure, the diseased tissue is removed from the back corneal layers and donor tissue is used to replace it.
After surgery, you will be prescribed eye drops and oral medications to help control swelling and pain resulting from the procedure. You will also be asked to wear an eye patch to protect your eye as it heals and you will need to be very careful and protect your eye from injury. As you heal, you will be able to slowly work back into everyday activities. It is very important for you to follow up with your eye care professional at all scheduled appointments as they are trained to catch complications as they develop.
With corneal transplants, donor tissue rejection is very rare. While this only happens in about 30% of cases, you need to be mindful of this complication as it is very serious. If you begin to experience eye pain, red eyes, cloudy or hazy vision, or are suddenly very sensitive to light, call Center for Sight at 850-476-9236 for immediate medical treatment as these could all be signs of corneal rejection.