Cornea Transplant

Corneal Transplant Surgery

A corneal transplant is a surgery that replaces the cornea — the clear window of tissue covering the front of the eye (aka “the windshield” of the eye).

The cornea’s purpose is to refract or bend light rays as they enter the eye and allow them to focus on the retina, or the back of the eye. In cases where the cornea has become clouded as a result of disease, swelling, scarring, infection, or traumatic injury, and cannot be healed or repaired, a full corneal transplant is sometimes necessary to restore functional vision.

The new cornea is sourced from a donor and then transplanted onto the affected eye.

Who’s A Good Candidate for a Corneal Transplant?

Those who have a deeply scarred or swollen cornea that cannot be corrected with non-surgical methods and treatments are possible corneal transplant candidates. Your Dean McGee Eye Institute (DMEI) ophthalmologist will examine your cornea to determine if a corneal transplant (including what type of transplant) is the best course of action.

The Procedure

During a corneal transplant, the surgeon will carefully remove the central corneal tissue and replace it with a precisely shaped replica of donor tissue to create the new cornea. This tissue is known as a graft.

All corneal transplant surgeries are done in the operating room with anesthesia. Your eye surgeon may choose between general anesthesia or an injection of medication to numb the eye. Once the procedure is finished, your eye will be covered with a patch and you will be monitored to ensure the anesthesia wears off properly and then allowed to go home.

Are There Any Risks With Corneal Transplant Surgery?

As with any surgery, there are risks associated with corneal transplant surgery. With corneal transplant surgery in particular, one of the most significant risks is tissue rejection. This is when the patient’s immune system identifies the donated tissue as foreign and begins attacking it. Rejection occurs in approximately 10% of cases. To reduce the risk of rejection, your physician will likely prescribe steroid eye drops and other medications that need to be taken very carefully as per instruction of the eye surgeon. It is also crucial that patients who receive corneal transplants attend all post-operative visits. The risk of rejection decreases with time, although it never completely goes away. Successful patients are those who attend all post-operative visits and take their eye medications as instructed by the corneal surgeon.

Other complications from corneal transplant surgery could include:

• Bleeding
• Swelling
• Infection
• Glaucoma
• Detached Retina

Your surgeon will discuss these risks in more detail with you, and together you can decide if a corneal transplant is right for you.

Preparing for a Corneal Transplant

Your DMEI ophthalmologist will talk with you about your upcoming corneal transplant and discuss what you can expect during and after the procedure. You will also discuss any medications you’ve been taking, and whether or not you must cease them prior to the surgery. A visit with your primary care doctor may be recommended to ensure you are healthy enough for the transplant.

You will not be able to drive after the surgery, so you will need to make arrangements for transportation afterwards.

Recovery Time

In most cases, vision returns very gradually following the procedure. During the healing process, which can vary from one patient to the next, the surgeon will continually monitor the surface of the eye.

Over a period of time, the surgeon may need to remove sutures. After most or all of the sutures have been removed, most patients will still need some type of vision correction (glasses or contact lenses). Every patient is different; depending on the type of corneal transplant surgery, patients may recover vision at different rates. Your corneal surgeon will provide more details as to the expectations of vision recovery during your visits.

Recovery Tips

• Use any eye drops as prescribed.
• Avoid touching or pressing on your eyes. You may wear eyeglasses or an eye shield to protect them.
• If necessary, you may take over-the-counter pain medicine, but check with your doctor first.
• No bending or heavy lifting (anything heavier than a gallon of milk) until instructed by your corneal surgeon.
• Attend all postoperative visits.