What is a Corneal Transplant?

A corneal transplant is a surgical procedure used to replace a patient's cornea with one from a deceased donor. Also known as keratoplasty, transplantation is a commonly employed to restore vision and reduce pain and discomfort when the patient's cornea is diseased or damaged. Performed as an outpatient procedure, there are potential complications and risks associated with corneal transplantation that should be discussed with a health care professional prior to surgery.

Successfully performed for the first time in 1905, corneal transplantation is utilized as a treatment for a variety of conditions that lead to the deterioration of the cornea. Conditions such as a thinning or clouding of the cornea, complications resulting from previous eye surgeries, or corneal ulcers can be corrected with a corneal transplant. Prognosis following the procedure is dependent on the success of the surgery, aftercare, and overall eye health.

Before a corneal transplant can be performed, the patient's condition must be evaluated. A comprehensive eye exam is conducted to ensure no conditions are present which could lead to complications following surgery, and the eye is measured to determine the size of donor cornea required. In cases where an underlying condition is discovered, such as inflammation or infection, it must be treated before proceeding with surgery.

Prior to the procedure, the patient is given a mild sedative to promote relaxation, and a local anesthetic is administered to numb the eye. The patient is conscious during surgery and should feel no pain. The entire thickness of the diseased cornea is precisely excised and replaced by the donor cornea, which is stitched into place with a delicate thread and later removed during a post-operative, follow-up visit.

Not all corneal transplants are conducted to excise the entire cornea. In some instances, only a partial transplant, known as a lamellar transplant, is needed. During a deep lamellar transplant, only the inner layer of the cornea is excised and a donor graft replaces the removed corneal portion. When the top-most layer of the cornea needs replacing, a surface lamellar transplant is conducted.

Following a corneal transplant, the patient is given medicated eye drops and oral medications to prevent infection, pain, and swelling. A protective metal eye patch and gauze are also used to protect the eye from injury and to minimize swelling. Once the cornea has healed, it can take several months for the patient to experience an improvement in vision.

Corneal rejection occurs when the immune system attacks the donor cornea. In cases of rejection, an additional corneal transplant is required. Symptoms of rejection include vision loss, sensitivity to light, and pain.

The overall risk of developing complications following corneal transplantation is minimal. Complications may include inflammation and irritation associated with the stitches, and rejection of the donor cornea. Risks associated with corneal transplant include eye infection, glaucoma, and cataracts.