The Basics of a Corneal Transplant

The cornea is the transparent layer of the eye that covers the pupil and iris. This protective outer layer functions as a window for light to enter the eye. Damages to this part of the eye can cause poor eyesight, and replacing the damaged cornea with a healthy one is the solution.

Who needs a cornea transplant?

A cornea transplant can be the solution for several conditions. These include:

Keratoconus (a condition that bulges the cornea in a cone shape)
Cornea scarring caused by injuries or infections
Complicated corneal ulcers caused by infections
Complications from previous eye surgeries
Hereditary eye diseases such as Fuchs’ dystrophy
Clouding, thinning, or swelling of the cornea

Unlike most transplant surgeries, a corneal transplant does not require tissue matching. Hence, the new cornea comes from people who decided to donate their cornea when they die. An eye donation is primarily a cornea donation.

What’s the procedure?

The doctors will do some lab tests and examinations to ensure the patient is in good health to receive the corneal transplant surgery. The patient will be asked to avoid taking aspirins a few weeks before the surgery. The patient will also be asked to use antibiotic eye drops on the day before the surgery to prevent infections.

The surgery is usually an outpatient procedure, which means the patient will get to go home the same day. The surgery takes about 30 minutes to an hour.

Depending on the damage level of the cornea, the doctors will choose one of these methods;

Penetrating Keratoplasty (PK): When the cornea is severely damaged, the doctors replace all layers of the cornea. Hence, this method is also called Full Thickness Corneal Transplant. This method might need stitches and has the longest healing
Endothelial Keratoplasty (EK): Endothelium is the innermost layer of the cornea. When this layer is damaged, Endothelial Keratoplasty is performed to replace the tissues from the back corneal layers.
Anterior Lamellar Keratoplasty (ALK): This method involves removing the front corneal There are different types of ALK to adapt to different levels of damage to the patient’s cornea.
Artificial Cornea Transplant: Some patients are not fit for the methods of usual corneal transplant procedures. This method is for them. An artificial cornea is used instead of a donor

What are the risks?

Cornea rejection is one of the major complications that can happen after the surgery, and it happens in 1 out of 10 surgeries. Cornea rejection is when the body’s immune system attacks and rejects the new cornea. Most of the time, this complication can be handled with eye drops.

Symptoms of cornea rejection;

Eye pain
Increased sensitivity to light
Redness
Vision loss

Other complications include;

Infection
Bleeding
Increased pressure in the eye (glaucoma)
Clouding of the lens (cataracts)
Retinal detachment
Cornea swelling

Recovery

After the surgery, the patient will require to take extra care of the eye to prevent infections and complications. The healing is accompanied by directions from the doctors. These include;

Take eye drops and other medications to control infection and
Wear eye patches, shields, or protective
Frequent follow-up
Avoid injuries and bright
Lie on the

The improvement of vision after a corneal transplant could take weeks or months. The eye needs time to adjust to the new cornea. It is normal for the eyesight to get worse before it gets better. The patient should follow up with the doctors every one or two years after the first year of corneal transplant. For most people who have this surgery, their vision and hope for life are restored!

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