Cornea Transplant Procedures

Cornea transplants restore vision if your cornea has been damaged due to injury, disease or illness. During the transplant, a new cornea provided by a donor who has died is used to replace the existing cornea. According to the National Eye Institute, approximately 40,000 cornea transplants are performed each year in the United States.

Identification

• The cornea is the clear layer of your eye that covers and protects the iris, the colored part of the eye. The cornea also works to focus and send light to the retina, the light-sensing layer at the back of the eye. When the cornea is damaged, it can become cloudy or scarred, reducing usable vision.

Reasons for Surgery

• While a transplant may be needed if your cornea is damaged due to illness or injury, the procedure may also be necessary if you suffer from swelling of the cornea, known as corneal edema. Corneal edema can occur due to an eye disease or as a complication of cataract surgery. When the cornea swells, vision is affected and small, painful blisters may eventually form on the surface.

  Keratoconus causes the cornea to thin out over time, eventually forcing it into a cone shape. This corneal curvature can make vision blurry and distorted. Transplant surgery may be needed if you suffer from corneal dystrophy, a disease that occurs when cells within the cornea grow abnormally. If you have a corneal dystrophy, you may experience vision problems, pain or a constant feeling that something is in your eye.

Before the Surgery

• When you and your doctor have decided that a cornea transplant is the best option to restore your vision, you will be placed on a waiting list for a donor cornea. You may be required to have pre-operative testing prior to the transplant surgery and might need to obtain pre-authorization for treatment from your medical insurance company. Aspirin, pain medication and medications that interfere with blood clotting may need to be stopped prior to surgery.

Cornea Transplant Procedure

• Before surgery begins, you will be given either local or general anesthesia. Your cornea will be carefully removed from your eye and the donor cornea will be sewn in its place. The sutures used to hold the new cornea in place with remain in your eye for up to 2 years before they are removed. After surgery, a shield will placed over your eye to protect it. Your vision may not be perfect immediately following surgery, but you can expect it to gradually improve as your eye becomes accustomed to the new cornea.

Recovery

• You will be given a prescription for eye drops that will help your eye heal and will need to use the drops daily for 2 or 3 months or more. If your surgery was an outpatient procedure, you will be able to go home soon after the procedure, but will need to have a friend or relative drive you. While you can resume your normal daily activities, you should avoid exercise or lifting objects over 25 pounds for 2 weeks. Rubbing or bumping your eye must also be avoided while the eye heals.

Other Procedures

• Partial-thickness cornea transplants are used to replace one part of the cornea. During a surface lamellar grant transplant, the outer layers of the cornea are removed and replaced, while a deep lamellar transplant is used to replace the inner layers of the cornea. These procedures are not appropriate for everyone. Some people will require a full cornea transplant due to extensive damage to the cornea.

  In some cases, a corneal transplant can be avoided with the use of phototherapeutic keratectomy (PTK). During PTK, a excimer laser removes damage and dystrophies from the very top layers of the cornea. New corneal tissue then grows to replace the layer that was removed.