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The cornea is the clear layer on the front of the eye.
A cornea transplant, which replaces damaged tissue on the eye’s clear surface, also is referred to as a corneal transplant, keratoplasty, penetrating keratoplasty (PK) or corneal graft.
A graft replaces central corneal tissue, damaged due to disease or eye injury, with healthy corneal tissue donated from a local eye bank. An unhealthy cornea affects your vision by scattering or distorting light and causing glare and blurred vision. A cornea transplant may be necessary to restore your functional vision.
Cornea transplants are performed routinely. In fact, of all tissue transplants, the most successful is a corneal transplant. It is one of the most common transplants done.
You will probably be awake during the transplant. Local anesthesia (numbing medicine) will be injected around your eye to block pain and temporarily prevent eye muscle movement. You may receive a sedative to help you relax.
The tissue for your corneal transplant will come from a person (donor) who has recently died and who previously agreed to donate their tissue. The donated cornea is processed and tested by a local eye bank to make sure it is safe for use in your surgery.
The most common type of corneal transplant is called “penetrating keratoplasty.” During this procedure, your surgeon will remove a small round piece of your cornea. Then your surgeon will sew the donated cornea into the opening of your eye.
Newer techniques may be used for some patients. During these, only the inner or outer layers of the cornea are replaced, rather than all the layers.
Why the Procedure is Performed?
- Vision problems caused by thinning of the cornea, usually due to keratoconus
- Scarring of the cornea from severe infections or injuries
- Vision loss caused by cloudiness of the cornea, usually due to Fuchs’ dystrophy
Recovering From a Cornea Transplant
- The total recovery time for a corneal transplant can be up to a year or longer. Initially, your vision will be blurry and the site of your corneal transplant may be swollen and slightly thicker than the rest of your cornea. As your vision improves, you will gradually be able to return to your normal daily activities.
- For the first several weeks, heavy exercise and lifting are prohibited. However, you should be able to return to work three to seven days after surgery, depending on your job. Steroid eye drops will be prescribed for several months to help your body accept the new corneal graft. You should keep your eye protected at all times by wearing a shield or a pair of eyeglasses so that nothing inadvertently bumps or enters your eye.
- Stitches usually are removed three to 17 months post-surgery, depending on the health of your eye and the rate of healing. Adjustments can be made to the sutures surrounding the new cornea to help reduce the amount of astigmatism resulting from an irregular eye surface.
Sight After a Cornea Transplant
- Your vision typically will continue to improve up to one year following your surgery. But you will need vision correction (glasses or contact lenses) for nearsightedness and astigmatism, because the curve of the corneal transplant cannot match exactly the curve of your existing cornea.
- Because your vision will fluctuate during the first three months following your surgery, it is typical to wait for that time period or until all of your sutures have been removed to fill an eyeglass prescription and be fitted for contact lenses.
- After healing is complete and stitches are removed, it is possible to undergo laser vision correction (LASIK or PRK) to improve your ability to see without glasses or contact lenses.
- Rigid gas permeable contact lenses, also known as RGP or GP lenses, and hybrid contact lenses typically provide the best vision correction for corneal transplant patients due to the irregularity of the cornea after transplant. However, soft contact lenses often are an option as well. In any case, using a contact lens that offers good oxygen permeability will minimize corneal swelling.