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Home » Your Eye Health » Eye Conditions » Corneal Transplant

Corneal Transplant

A cornea transplant, also known as keratoplasty or a corneal graft, replaces damaged tissue on the clear front surface of the eye.

When disease or injury damages the cornea, eyesight is affected. Light that enters the eye becomes scattered, resulting in blurred or distorted vision. When the cornea is extremely scarred or damaged, a corneal transplant is needed to restore functional vision.

Keratoplasty is performed routinely and is regarded as the most successful of all tissue transplants. According to the National Keratoconus Foundation, over 40,000 cornea transplants are done annually in the United States.

In recent years, an innovative type of corneal transplant has gained popularity. Known as Descemet’s Stripping Endothelial Keratoplasty (DSEK), this new procedure removes a smaller and thinner portion of the cornea. In 2009, DSEK was declared by the American Academy of Ophthalmology as superior to the conventional surgery because it may provide better vision outcomes and more eye stability. It is also associated with less risk factors. However, when the majority of the cornea is damaged, a more comprehensive removal may still be necessary to facilitate a successful transplant.

Criteria for a Corneal Transplant

A multitude of reasons indicate candidacy for a corneal transplant. Possible reasons include:

  • Eye diseases, such as keratoconus
  • Complications from laser surgery, such as LASIK
  • Extreme inflammation on the cornea
  • Scarring as a result of infections, such as eye herpes or fungal keratitis
  • Thinning of the cornea and an irregular shaped cornea
  • Hereditary factors
  • Corneal failure due to previous surgical procedures
  • Chemical burns or injuries that damaged to the cornea

Cornea Transplant Procedure

Once a patient has been recommended and approved for a corneal transplant to restore vision, the patient’s name is added to a list at an eye bank. The United States has a very advanced eye bank system, and the general wait time for a donor eye is one to two weeks. The tissue of donor corneas is checked for clarity and screened meticulously for disease before it is released for transplant.

The actual surgery is generally performed as an outpatient procedure that does not require hospitalization. General or local anesthesia may be used, depending upon the patient’s preference, age and health condition. Local anesthesia is injected into the skin surrounding the eye, which relaxes the muscles that control movement and blinking. Eye drops numb the eye itself.

Once the anesthesia has taken effect, the surgeon inspects and measures the damaged corneal area in order to decide upon the size of the transplantation. Eyelids are held open during this time. The surgeon then removes a round, button-shaped piece of the corneal tissue and replaces it with a nearly identical sized button of donor tissue. The new, healthy tissue is sutured into place. The entire procedure takes approximately one to two hours.

Following the surgery, a plastic shield must be worn over the eye in order to protect it against any inadvertent bumps or rubbing.

Rejection of the Corneal Graft

Although the vast majority of cornea transplants are successful, sometimes the new tissue is rejected. Warning signs of rejection include:

  • Extreme sensitivity to light
  • Redness
  • Pain
  • Decreased vision

These symptoms may be experienced as soon as one month after the surgery, or as delayed as five years later. Medications can be prescribed to reverse the rejection process. If the corneal graft fails completely, the transplant can be repeated and the outcome is generally positive. Yet the total rejection rates do increase with the total number of corneal transplants.

Recovery and Healing

It can take up to a year or longer to heal completely from a corneal transplant. At the beginning, vision is blurry and the transplant site is often swollen and thicker than the rest of the cornea. As vision returns, patients are able to return to normal daily tasks and most people can return to work within three to seven days after surgery. However, heavy lifting and exercise must be avoided for the first few weeks.

To help the body accept the corneal graft, steroid eye drops must be applied for several months. A pair of eyeglasses or a protective shield must also be worn for eye safety. Depending upon the health of the eye and the healing rate, stitches may be removed at any time from three months to more than a year later. Astigmatism often occurs as a result of an irregular corneal surface, and adjustments may be made to the sutures around the new cornea in an effort to reduce this problem.

Vision after a Cornea Transplant

Vision improvement after a cornea transplant is a process that can last up to one year later. Eyeglasses or contact lenses must be worn immediately after the surgery, since the curvature of the corneal transplant will not precisely match the natural corneal curve.

When healing is complete and stitches are removed, laser surgery may be indicated to correct vision. LASIK or PRK are both procedures that can help decrease dependence on eyeglasses or contacts. An irregular corneal surface may point to the need to wear rigid gas permeable (GP) contact lenses for vision correction.

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Update on COVID-19 (03/30/2020)

We wanted to thank you for your continued support of our office during this challenging time. We will continue to be open from 9:00am-1:00pm Monday through Friday to dispense contact lens and eyeglasses orders. We will also be able to order additional contact lenses for patients who may be running low.

While all routine eye care is still deferred during this time, we will remain available to triage eye emergencies. We will send out additional notifications as soon as it becomes possible to resume routine eyecare.

Please call or text us at (904)287-4567 or email us at cfec2@2drfishers.com with any questions for concerns.

*****CONTACT WEARERS*****

With the day to day changes surrounding COVID-19, we do not know how much longer we will be open to the public. With that being said, if you are a contact lens wearer, and currently have less than a 3 month supply of lenses, we highly recommend that you place an order now. We will offer free shipping on lenses directly to your home (with a minimum of 2 boxes). We will also extend contact lenses prescriptions, as needed, for those expiring within the next three months.

Please call or text us at (904)287-4567 or email us at cfec2@2drfishers.com.

Hours: As of March 30, we will be open from 9:00am – 1:00pm Monday through Friday only to dispense contact lens and eyeglass orders. We will have a doctor available to see ocular emergencies if needed.

Routine Eye Exams: If you are scheduled for a routine eye examination appointment during our closure, we will reschedule your appointment. As of March 30, 2020, we will begin rescheduling routine eye examination appointments for April 13th and later.

I need to replace my glasses. What do I do? Please contact us at (904)287-4567. We may be able to extend your prescription during this time and will help you with your eyewear needs.

I’m nearly out of contact lenses. What do I do? Please contact us at (904)287-4567. We may be able to extend your prescription during this time, and/or place an order for your contact lenses and have them shipped to your house (with a minimum of 2 boxes).

I need a refill on the medication prescribed to me by the practice. What do I do? Please contact us at (904)287-4567 or cfec2@2drfishers.com. We can transmit a refill for your prescription directly to your pharmacy so that you have the medication that you need.

I need to pick up my order. What do I do? We will be open from 9:00am – 1:00pm Monday through Friday only to dispense contact lens and eyeglass orders.

I don’t feel comfortable coming into the office to pick up my order. What do I do? Please contact us at (904)287-4567 and we can bring your contact lens or glasses order out to your car. Since we are working with reduced staff, please allow us extra time for curbside pick-up. Also, when you place your contact lens order, you can elect to have them shipped to your home.

What about an eye emergency after your shortened business hours? What can I do? If you have an ocular emergency, please call (904)287-4567 and wait for instructions at the end of the message.

Our doctors will do their best to accommodate your needs whenever possible during this time. We have reduced our staff hours until further notice to protect them, our patients, our community, and our nation. Despite the financial and emotional hardships this will cause, we ask every one of you to do the same.

Together, we will weather this storm.