About Corneal transplantation:

Cornea transplantation is a surgery used to replace a damaged cornea with a healthy, donated one. Some surgeries remove the entire cornea, while others only remove a few parts. The surgery is used to treat different corneal diseases. It is often the last way to treat corneal infection and save sight. In most cases, the surgery is very successful.

Why is the corneal transplant done?

The cornea may be severely damaged by:

  • Keratoconus (Forward bulging of the cornea)
  • Cornea infection or injuries
  • Corneal ulcers (Keratitis)
  • Corneal Edema & decompensation

About the Surgery:

The surgery usually is finished within 1 to 1 ½ hours. An anaesthetic will be used so patients don’t feel any pain. In corneal transplant,

  1. The eye is held open with a speculum (A)
  2. A laser is used to make an initial cut in the existing cornea (B)
  3. The surgeon uses scissors to remove it (C)
  4. The donor cornea is placed (D)
  5. It is stitched with very fine sutures (E)
Picture Courtesy: Surgery Encyclopedia

Types of Corneal Transplantation Surgery

There are two main types of corneal transplantation surgery:

Full Thickness:

  1. Therapeutic Keratoplasty: for corneal ulcers
  2. Penetrating Keratoplasty: for keratoconus

Lamellar/Partial Thickness:

  1. DMEK/DSAEK for Pseudophakic bullous keratopathy & Fuchs’ dystrophy
  2. DALK for Keratoconus, Partial thick scar

Risks & Complications

Cornea transplant is a serious surgery. Even though it is safe, it does have a risk for complications, including:

  • Eye infection
  • Glaucoma
  • Problems with the stitches
  • Rejection of the donor cornea

Corneal Rejection:

Rejection occurs when patient’s body attacks the donor’s cornea tissue. Symptoms of rejection include red eye, sensitivity to light, cloudy vision, and eye pain. Tell an eye doctor right away if you notice these symptoms. With early detection, it can be treated with steroid eye drops.

Preparing for Surgery:

Before Surgery:

  1. Get an eye exam from an eye doctor to make sure the surgery is safe
  2. Inform the doctor of all the medicines and treatments you are taking

After the Surgery:

Follow the doctor and counsellor’s instructions closely. Take eye drops or medicines as advised.

  1. Protect your eye from injury
  2. Return for follow-ups with an eye doctor
  3. Avoid bathing in unclean river water

Results

The results will depend on the extend of corneal damage. Most people will have at least some vision improvement. It is important that you come for follow-ups to make sure that your eye is healing properly.

Why do I need a corneal transplant?

The cornea is the clear cover on the surface of your eye. Your cornea may be cloudy, causing you to lose vision. If this is the case, a clear donor cornea should fix the problem. Your cornea can also be damaged by other diseases, infections, and injuries.

After the surgery, will I have any pain or irritation? How long will it take for these side effects to go away?

You will only have a little bit of pain and it should only last for a few days after the surgery. To control the pain, you will take painkillers. In a few cases, the stitches/sutures may break. This will irritate the eye. The sutures may need to be replaced.

How many days will I have to stay in the hospital after the cornea transplant?

This depends on the type of transplant.

  • Therapeutic penetrating keratoplasty (TPK): 3 days
  • Penetrating Keratoplasty (PKP): 3 days
  • DSAEK/DMEK/DALK: 3 days

Depending on the eye condition, some patients might need to stay someone days.

How many days until my vision gets better?

Vision should get batter within 3 months of the surgery. If your doctor tells you to wear glasses, you will need to wear them for vision to improve.

How many months will I need to take medications?

You will need to take them for at least 6 months to 1 year. Depending on the doctor’s advice, you may need to continue them past the 1 year.

When do I have to come for a follow-up?

You will need to visit your eye doctor after 1 month, 3 months, and 6 months. Sometimes, the doctor may ask you to come back more frequently.

When can I take a head bath?

Usually after 1 month. You should wait for the doctor to tell you that the wound has healed. Also, avoid bathing in river water.