Corneal Transplant Surgery: What You Should Know

hargrave eye centerYou may need a cornea transplant if your cornea no longer lets light enter your eye properly because of scarring or disease.  The first cornea transplant was performed in 1905 by Eduard Zirm (Olomouc Eye Clinic, now Czech Republic), making it one of the first types of transplant surgery successfully performed.  

According to the Mayo Clinic, a cornea transplant, also called keratoplasty, is a surgical procedure to replace part of your cornea with corneal tissue from a donor. Your cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of your eye’s focusing power.  A cornea transplant can restore vision, reduce pain and improve the appearance of a damaged or diseased cornea.  Most cornea transplant procedures are successful. But cornea transplant carries a small risk of complications, such as rejection of the donor cornea.

Types of cornea transplants include:

  • Penetrating (full thickness) cornea transplant. This involves transplanting all the layers of the cornea from the donor.
  • Lamellar cornea transplant. During this procedure, the surgeon only replaces some of the layers of the cornea with the transplant.

ocular healthExperts know more about the long-term success rates of penetrating cornea transplants, which use all the layers of the cornea.  Success rates are also affected by the problem that needed to be fixed with the transplant. For example, research from WebMD has found that the new cornea lasts for at least 10 years in:

  • 89% of people with keratoconus
  • 73% of people with Fuchs’ dystrophy
  • 60% to 70% of people with corneal scarring

The cornea tends to heal slowly. To help protect your eye in the days after the surgery, your doctor may ask you to wear a protective shield over it.  You will need to use eyedrops for several months after the transplant which can then be reduced to one drop a day or discontinued. The stitches may remain in your eye for months or years. Your eye doctor can remove them in a simple procedure during an office visit.  Your vision may improve slowly after the surgery. It’s important to avoid any possible trauma to your eye, such as from sports. This can damage your new cornea. You should report new irritation or any decrease in vision to your corneal surgeon. These may be signs that your body is rejecting the donor cornea. Most transplant rejections are fully reversible with steroid eyedrops if detected early enough.  Rejection may even occur years after the surgery. If you notice any of these signs that last for more than six hours, call your eye doctor promptly. The doctor can give you medicine that can help prevent as well as treat rejection.

Eye donors are screened to eliminate those with diseases that may be transferred to you via the donor cornea. The donor’s general and eye medical history are reviewed, and blood tests are performed for hepatitis and AIDS. AIDS has never been transmitted via corneal transplant, but it is tested as a precaution. While none of these tests are infallible, there is only a remote chance of transmitting disease via corneal transplantation.