Corneal transplant: procedures, functions and risks

Definition

Corneal transplant is an operation used to remove all damaged parts of the cornea of the eye and replace it with healthy corneal tissue from the appropriate donor eye. Quoted from the Mayo Clinic, this procedure can restore vision, reduce pain, and improve the appearance of a damaged or sore cornea.

Corneal transplants aim to improve vision in people with the following conditions:

The protruding cornea (keratoconus)
Fuchs' dystrophy
Corneal thinning
Corneal scratches, caused by infection or injury (keratitis)
Cornea is blurry
Swollen cornea
Corneal ulcers, including those caused by infection
Complications due to previous eye surgery

Precautions & warnings

What should I know before having corneal transplant surgery?

Most people who receive a corneal transplant will have restored vision, at least half. The results of a corneal transplant depend on the reason for the operation and your medical condition.

The risk of complications and corneal rejection (mismatch) can occur several years after the corneal transplant is performed. Therefore, make sure check up to an ophthalmologist every year. Corneal rejection can usually be resolved with medication.

Find a corneal donor

Most of the corneas used in this procedure are obtained from donors who have died. Unlike other organs, such as the liver or kidneys, people who need a corneal transplant generally don't have to wait too long.

This is because many people specifically allow their corneas to be donated after they die, unless they have certain conditions. Thus, there is a significant proportion of the cornea available for transplant than any other organ.

Some conditions that prevent a person from donating their corneas include having certain central nervous system problems, infections, or having had eye surgery. You also cannot get corneal donors from people who have no known cause of death.

Different types of glasses and contact lenses may help. Some types of keratoconus can be treated with surgery in which a small plastic ring is placed inside the cornea. If you have endothelial decompensation, eye drops can help. All of these methods will become less effective as the disease worsens.

Process

What should I do before doing this operation?

Before corneal transplant surgery, you will undergo:

Eye examination thorough. The doctor will check if there are any conditions that might cause complications after the operation
Eye measurement. The doctor will check what size corneal donor you will need
Tell me all the drugs you use. You may need to stop using certain medications or supplements before or after this procedure
Treatment for other eye problems. Before having surgery, you may need treatment for other unrelated eye problems, such as infection or inflammation, to reduce the success of this procedure. Your eye doctor will try to resolve this problem before surgery

How is the corneal transplant surgery process?

The operation usually takes 1-2 hours. Your surgeon will remove the center of the diseased cornea, and replace it with the corneal portion of the donor.

You will also be sedated before undergoing surgery. The anesthesia given will depend on your needs as determined by your doctor.

The doctor can replace all of your cornea, only the outer layer, or only the inner layer. The doctor will use small sutures to hold the cornea or the new part of the cornea in place.

What should I do after surgery?

Many people spend the night in the hospital, but you may also be able to go home the same day. The doctor will give you eye drops and sometimes medicine to take home.

You should not swim or lift heavy objects until you have been checked again by your surgeon. Before exercising, seek advice from your doctor to make sure this exercise is safe for your condition.

Many people are recovering well. However, it may take up to a year for your eyes to get better.

You may need another operation to change the shape of the cornea. Your doctor will ask you to return to the clinic regularly so they can check if the transplant is recovering well and check for signs of rejection.

Complications

What complications can occur?

A whole corneal transplant is a safe procedure. However, corneal transplants also carry a small risk of serious complications, such as:

Eye infection
Increased risk of fog in the lens of the eye (cataract)
Increased pressure inside the eyeball (glaucoma)
Problems with the sutures used to attach the donor's cornea
Donor corneal rejection
Swelling of the cornea

In some cases, your immune system can mistakenly attack the donated cornea. This is called rejection, and it can require medical treatment or another corneal transplant. Rejection occurs in about 20% of these procedures.

Make an appointment with your eye doctor if you notice any signs or symptoms of corneal rejection, such as: