Corneal Transplant

Conditions:

• Corneal failure after other eye surgery, such as cataract surgery
• Keratoconus, a steep curving of the cornea
• Hereditary corneal failure, such as Fuchs' dystrophy
• Scarring after infections, especially after herpes
• Rejection after a first corneal transplant
• Scarring after injury

What to Expect:

Surgery is often done on an outpatient basis. You may be asked to skip breakfast, depending on the time of your surgery. Once you arrive for surgery, you will be given eyedrops and perhaps a sedative to help you relax. Either local or general anesthesia is used, depending on your age, medical condition, and eye disease. You will not see the surgery while it is happening. Your eye will be held open with a lid speculum or another method.

The eyelids are gently opened. Your eye surgeon will view your eye through a microscope and measure your eye for the corneal transplant. The diseased or injured cornea is carefully removed from the eye. Any necessary additional work within the eye, such as removal of a cataract, is completed. Then the clear donor cornea is sewn into place. When the operation in over, your doctor will usually place a shield over your eye.

If you are an outpatient, you may go home after a short stay in the recovery area. You should plan to have someone drive you home. An examination at the doctor's office will be scheduled for the following day.

Post Surgery Instructions:

• Use the eyedrops as prescribed
• Be careful not to rub or press on your eye
• Use over-the-counter pain medicine, if necessary
• Continue normal daily activities but avoid strenuous exercise or activities
• Wear eyeglasses or an eye shield for protection, as advised by your doctor
• Ask your doctor when you can start driving again
• Call your doctor if you have any questions about your home-care instructions

Your eye doctor will decide when to remove the stitches, depending upon the health of your eye and rate of healing. Usually, it will be one year before stitches are removed, but this varies depending on the specific technique used. Often, stitches are left in place permanently.

Risks

Eye surgeons perform more than 40,000 corneal transplants each year in the United States. Of all transplant surgeries done today, including heart, lung, and kidney, corneal transplants are the most common and successful.

Corneal transplants are rejected 5% to 30% of the time. The rejected cornea clouds and vision deteriorates.

Most rejections, if treated promptly, can be stopped with minimal injury. Warning signs of rejection are:

• Persistent Discomfort
• Light Sensitivity
• Redness
• Change in Vision

Any of these symptoms should be reported to your Eye Doctor immediately.

Other possible complications include:

• Infection
• Bleeding
• Swelling or detachment of the retina
• Glaucoma

All of these complications can be treated.

Even if the surgery is successful, other existing eye conditions, such as macular degeneration, glaucoma, or diabetic retinopathy, may limit vision after surgery. Even with such problems, a corneal transplant may still be worthwhile.