Cornea Transplant

Also known as keratoplasty, a cornea transplant is a surgical procedure that s done 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 the damaged or diseased cornea. Most corneal transplants are successful.

However, complications, such as rejection or the donor cornea may be accompanied by this procedure.

The main reason for a cornea transplant is to restore vision to an individual who has a damaged cornea.

A cornea transplant may also be used to relieve pain and other signs and symptoms associated with diseases of the cornea.

Several conditions can be treated using a cornea transplant:

• Fuch's dystrophy.
• A cornea that bulges outwards (keratoconus).
• Thinning of the cornea.
• Clouding of the cornea.
• Swelling of the cornea.
• Complications caused by previous eye surgery.
• Corneal ulcers, including those caused by infection.
• Corneal scarring caused by infection or injury.

A cornea transplant is quite safe, however, it still carries a small risk of serious complications, such as:

• Eye infection.
• Increased risk of clouding of the eye's lens (cataracts).
• Pressure increase within the eyeball (glaucoma).
• Problems with the stitches used to secure the donor cornea.
• Swelling of the cornea.
• Rejection of the donor cornea.

Signs and symptoms of corneal rejection. In some situations, your body's immune system may unknowingly attack the donor cornea.

This is called rejection, and may require medical treatment and possibly another transplant.

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

• Loss of vision.
• Pain.
• Sensitivity.
• Redness.
• Rejection occurs in about 20 percent of corneal transplants.

To prepare for a cornea transplant, you will need to undergo the following:

A thorough eye exam. In this exam, your eye doctor will look for conditions that might potentially cause problems after the surgery.

Measurements of your eye. Your doctor will determine the size of the donor cornea you will need. A review of all medications and supplements you are taking.

May have to stop taking certain medications or supplements before or after your cornea transplant. Treatment for other problems related to the eye.

Unrelated eye problems such as infection or inflammation may reduce your chances of a successful cornea transplant. Your eye doctor will work to solve these problems before your cornea transplant.

Your doctor will also discuss what to expect during the procedure and explain the risks of the procedure. Finding a donor cornea. The majority of corneas that are used in transplanting come from deceased donors.

Unlike, other organs, such as livers or kidneys, people waiting for corneal transplants do not usually way for long periods of time before acquiring one.

That is simply because a lot of people specifically request their corneas be available for donation when after they die, unless they have had certain conditions, so more corneas are available for transplantation compared with other organs.

Corneas may not be used from donors who had a number of conditions, such as certain central nervous system conditions, infections, or from individuals who died from an unknown cause.

Read on to learn more about what to expect before, during, and after your cornea transplant.

During your cornea transplant. You will be sedated so that you can be relaxed and a local anesthetic will also be given to you to numb your eye. You will not be asleep during the surgery, but you should not feel any pain.

During the most known type of cornea transplant (penetrating keratoplasty), your surgeon will cut through the entire thickness of your abnormal or diseased cornea to remove the small button-sized disc of corneal tissue.

An instrument that acts like a cookie cutter (trephine) is used to take this precise circular cut. The donor cornea, which is cut off to fit, is placed in the opening.

Your surgeon will then use a fine thread to stitch the donor cornea into place. The stitches may be removed at a later visit when you see the doctor. Procedures to transplant a portion of the cornea.

With some types of cornea problems, a full thickness cornea transplant is not always going to be the best treatment. Partial-thickness (lamellar) transplants may be useful in certain situations.

The following are this kind of procedures: Replacing the inner layer of the cornea. Also known as a deep lamellar transplant, this procedure replaces the innermost layer of your corneas five layers.

Tiny incisions then made on the side of your eyeball to allow the removal of your cornea's innermost layer without damaging the other external layers.

A donor graft is the fixed to replace the removed portion. Replacing the surface layer of the cornea.

The outer layer of the cornea that have been damaged by particular diseases and conditions can be replaced with the use of a procedure that is commonly known as the surface lamellar transplant.

A surface layer can also be removed and replaced with a donor graft. After your cornea transplant.

After completion of the procedure, you can expect to do the following:

• Receive several medications.
• Eye drops, and in some cases, oral medications may be administered immediately after the procedure and continuing during your recovery will help control infection, swelling and pain.
• Wear an eye patch. This help protects your eye during the healing process following surgery.
• Protect your eye from injury.

Make sure you take it easy after your cornea transplant, slowly working your way up to your normal day to day activities, including exercise.

For the remainder of your life, you will need to be more careful to avoid harming your eye. Return for frequent follow-up exams.

You must expect frequent eye exams in which your doctor looks for complications in the first year after surgery.

Most individuals who undergo a cornea transplant have their vision restored to a certain degree. Your results will largely depend on the reason for your surgery and your health.

Your risk of complications and cornea rejection continues for years beyond the initial transplant. For this reason, you must expect to see your eye doctor annually.

Cornea rejection can often be managed with medications. Vision correction after surgery. Your vision may be worse than before at the beginning as your eye has to make adjustments to the new cornea.

It may take a number of months for your vision to improve. Immediately the outer layer of your cornea has healed, in a period of several to months after surgery.

Your eye doctor will proceed to make adjustments that can improve your vision, such as:  

• Correcting astigmatism (unevenness in your cornea).
• The stitches that hold the donor cornea in place on your eye may lead to dips and bumps on your cornea, making your vision blurry in spots.
• Your doctor may make corrections to some of this by releasing some stitches and tightening others.
• Correcting vision problems.
• Refractive errors, such as nearsightedness (myopia) or farsightedness (hypermetropia), can be corrected with glasses, contact lenses or, in some cases, laser eye surgery.