Surgery Center

Cornea Surgery

What conditions may require corneal transplants?

• corneal failure after other eye surgery, such as cataract surgery;
• kerataconus, a steep curving of the cornea;
• hereditary corneal failure, such as fuch's dystrophy;
• scarring after injections, especially after herpes;
• rejection after first corneal transplant;
• scarring after injury.

What happens if you decide to have a corneal transplant?

Before Surgery
Once you and your opthalmologist decide you need a corneal transplant, your name is put on the list at the local eye bank. Usually, the wait for a donor cornea is not very long.

Before a cornea is released fror transplant, the eye bank tests the human donor for viruses that cause hepatitis and AIDS. The cornea is carefully checked for clarity.

Your opthamologist may request that you have a physical examination and other special tests. If you usually take medications, ask your doctor if your should continue using them.

The Day of Surgery
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 other method.

The Operation
The eyelids are gently opened. The opthalmologist will view your eye through a micropscope and measure your eye for the corneal transplant.

The diseased or injured cornea is carefully removed from the eye and the new cornea is put into place.

When the operation is over, the opthalmologist will usually place a shield over your eye.

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

You will need to:

• use the eyedrops as prescribed;
• be careful not to rub or press on your eye;
• use over-the-counter pain medication, if necessary;
• contine normal daily activities, except exercise;
• ask your doctor when you can begin driving;
• wear eyeglasses or an eye shield as advised by your doctor;
• if you have any questions about your home care instructions, call your doctor.

Your opthalmologist will decide when to remove the stitches, depending upon the health of the eye and rate of healing. Usually, it will be several months before stiches are removed.

What complications can occur?

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 rejections are:

• persistent discomfort;
• light sensitivity;
• redness;
• change in vision.

Any of these symptoms should be reported to your opthalmologist immediately.

Other possible complications include:

• infection;
• bleeding;
• swelling or detachment of the retina;
• glaucoma.

All of these complications can be treated.

A corneal transplant can be repeated, usually with good results, but the overall rejection rates for repeated transplants are higher than for the first transplant.

Irregular curvature of the transplanted cornea (astigmatism) may slow the return of vision but can also be treated. Vision may continue to improve up to a year after the surgery.

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

A successful corneal transplant requires care and attention on the part of both patient and physician. However, no other surgery has so much to offer when the unhealthy cornea is deeply scarred or swollen.

*Corneal transplant surgery would not be possible without the thousands of generous donors and their families who have donated corneal tissue so that others may see.

Please email us at cornea@anderseneye.com for more information.