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Home » Your Eye Health » Vision Surgery » Corneal Transplants

Corneal Transplants

The cornea refers to the clear, front surface of your eye. When a corneal transplant is done, officially termed keratoplasty (KP), the central part of the cornea is surgically removed and replaced with a “button” of clear and healthy corneal tissue donated from an eye bank.

According to the National Eye Institute, approximately 40,000 corneal transplants are performed annually in the United States. The overall success rate for keratoplasty is relatively high, yet up to 20% of patients may reject their donor corneas. Aggressive medical treatment with steroids is generally given in response to signs of rejection, and it is often effective at subduing the negative reaction and saving the cornea. At five to ten years after KP surgery, studies report an encouraging success rate of 95% to 99%.

Why are corneal transplants done?

Corneal transplants are typically done when the cornea becomes damaged or scarred in a way that uncorrectable vision problems occur. These types of vision conditions are not resolved by eyeglasses, contact lenses or refractive laser surgery (such as LASIK). Disease or injury is the usual culprit for the vision loss.

Keratoconus is a common reason for needing a corneal transplant. In this degenerative condition, the cornea thins and bulges forward in an irregular cone shape. Rigid gas permeable (GP) contact lenses can treat mild cases by flattening the cornea, yet contacts are not effective when it comes to advanced stages of keratoconus. The National Keratoconus Foundation reports that 20% to 25% of people with keratoconus will require corneal transplant surgery to restore vision. Other corneal degenerative conditions will also result in a need for keratoplasty.

Corneal ectasia is a thinning and bulging of the cornea that sometimes occurs after LASIK or other refractive vision correction procedures. In the event that this happens, a corneal transplant may be needed to restore vision.

Corneal scarring, due to chemical burns, infections and other causes, is an additional reason that a corneal transplant may be indicated. Traumatic injuries to the eye are also commonly responsible.

Corneal Transplant Procedure

Keratoplasty is generally done on an outpatient basis, with no need for overnight hospitalization. Depending upon age, health condition and patient preference, local or general anesthesia is used.

Using a laser or a trephine, this is an instrument similar to a cookie cutter, the surgeon cuts and removes a round section of damaged corneal tissue and then replaces it with the clear donor tissue.

Extremely fine sutures are used to attach the donor button to the remaining cornea. The sutures remain in place for months (sometimes years) until the eye has recuperated, healed fully and is stable.

Recovery from a Corneal Transplant

The total healing time from keratoplasty may last up to a year or longer. At first, vision will be blurred and the site of the corneal transplant may be inflamed. In comparison to the rest of the cornea, the transplanted portion may be slightly thicker. For a few months, eye drops are applied to promote healing and encourage the body to accept the new corneal graft.

A shield or eyeglasses must be worn constantly after surgery in order to protect the healing eye from any bumps. As vision improves, patients may gradually return to normal daily activities.

What happens to vision post-keratoplasty?

Some patients report noticeable improvement as soon as the day after surgery. Yet a great deal of astigmatism is common after a corneal transplant. A patient’s prescription for vision correction tends to fluctuate for a few months after the surgery, and significant vision changes may continue for up to a year.

Hard, gas permeable contact lenses generally provide the sharpest vision after a corneal transplant. This is due to a residual irregularity of the corneal surface. Even with rigid contact lenses, eyeglasses with polycarbonate lenses must be worn in order to provide adequate protection for the eye.

Once the sutures are removed and healing is complete, a laser procedure such as LASIK may be possible and advised. Refractive laser surgery can reduce astigmatism and upgrade quality of vision, sometimes to the point that no eyeglasses or contact lenses are needed.

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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.