Corneal Surgery/Transplant

If your cornea – the transparent part that covers the front of the eye is damaged, you may experience eye pain, blurred vision, and/or cloudy vision. Your ophthalmologist can determine the cause of these symptoms. If your cornea cannot be repaired using alternative methods, recommend a cornea transplant.

A cornea transplant is a procedure to replace the clear front layer of your eye. During the surgery, damaged or diseased corneal tissue is removed and replaced with healthy corneal tissue from the eye of a human donor, thereby restoring clear vision.

Conditions that can damage your corneas and, as a result, impair your vision and require corneal surgery include:

• Fuchs’ dystrophy, in which the inner layer cells of the cornea die, causing it to swell and thicken blurring your vision.
• Keratoconus, which causes the cornea to become cone-shaped rather than dome-shaped.
• Infection that cause permanent damage to the cornea.
• Traumatic eye injuries that scar or penetrate the cornea.
• Bullous keratopathy, a painful blistery swelling of the cornea.
• Keratitis, in which a virus, bacteria, fungi, or parasites causes inflammation of the cornea.

How a Cornea Transplant is Performed

There are three surgical options for a cornea transplant depending on the cause of the damage, the condition of your cornea, and your specific needs:

• Penetrating keratoplasty – Also known as full thickness cornea transplantation, this method involves your surgeon using a small circular blade to remove the entire center part of the damaged cornea and replacing it with a healthy, same-shaped part of donor cornea.
• Deep anterior lamellar keratoplasty – This partial thickness cornea transplant is performed if the innermost layer of your cornea is healthy, but the middle and out layers are damaged. During the procedure, your surgeon removes these layers of the cornea and replaces them with healthy corneal tissue.
• Endothelial keratoplasty – This procedure is appropriate if the innermost layer of your cornea, known as the endothelium or Descemet’s membrane, is damaged.

Before and After Corneal Transplant Surgery

Before the surgery, your doctor and anesthesia team review your medical history, provide answers to your questions, and finalize the surgical plan. The anesthesia team are responsible for administering either sedation or general anesthesia and applying numbing medication to your eye.

Corneal transplant surgery is an outpatient procedure that typically takes less than two hours to perform.

You can expect your eye to be red, irritated, and sensitive to light for the first few days following surgery. Any pain you experience can be controlled with recommended over-the-counter pain relievers. You will have to wear an eye patch after surgery, especially when you shower and sleep, and you will have to avoid certain activities as advised by your surgeon. With an endothelial transplant, you will need to position yourself on your back for a few days after the procedure.

Within 24 to 48 hours of surgery, you will have a follow-up visit with your surgeon where the eye patch will be removed, and your eye will be examined for healing. Eye drops and ointments that are both antibiotics and corticosteroids to prevent infection and reduce swelling, inflammation, and rejection will be prescribed.

Depending on the type of surgical technique and sutures used, stitches may need to be removed, but not for several months. Your surgeon may recommend that you wear protective eyewear for a while to help protect your eyes. Also, while recovering, you should not rub or press your eyes as it may damage or interfere with your healing.