Marc A. Goldberg MD, Ophthalmologist
Corneal and Refractive Surgery - Advanced Cataract Surgery
Infectious & Immune Diseases of the Eye - General Ophthalmology
918.584.4433
Home | Corneal Transplant Surgery | Cataracts | Laser/Refractive | About Dr Goldberg
Corneal Transplant Surgery |
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When is corneal transplant surgery necessary? Treatment Risks of corneal transplant surgery Convalescence |
When is corneal transplant surgery necessary?The cornea is a clear dome of tissue that covers the front central portion of the eye. It functions primarily as the window to the eye. It allows light into the eye and bends (refracts) the light rays to help the lens focus them upon the retina. The normal cornea is completely transparent living tissue. To perform properly, the cornea must be crystal clear and be of a proper curvature.Due to injury or disease, the cornea may become damaged and opaque or may develop uncorrectable changes in its curvature. If the cornea is not perfectly clear, light may no longer effectively pass through it, resulting in diminished vision. If the cornea is irregular or damaged, or irregularly curved, it will cause blurred vision. Replacing a cloudy, damaged, or cone-shaped corneal tissue with healthy donor tissue through a corneal transplant can make a dramatic improvement in vision. There are many causes of clouding of the cornea. They include:
top of pageHow is corneal transplant surgery performed?The corneal transplant operation is usually performed under general anesthetic, depending on what the doctor believes to be in the patient's best interests. The surgeon removes the center of the cloudy cornea and replaces it with the clear donor cornea. The donor tissue is sewed in place.If a cataract is present the surgeon can remove it as part of the corneal transplant operation. If an artificial lens is already in place in the eye and it is believed to be responsible for the clouding of the cornea, the artificial lens can be replaced with a type of lens less likely to irritate the donor cornea tissue. top of pageRisksJust as is true with any operation, corneal transplant surgery entails some degree of risk. The success of the transplantation surgery is often related to the original cause of the underlying corneal disease process. Transplant procedures resulting from abnormally shaped corneas due to keratoconus or for corneal clouding following cataract surgery typically have very high success rates. Transplants due to scarring of the cornea from infections, such as herpes, may have a lower though still favorable success rate.Corneal transplant rejection can occur in about 1 in 10 patients. Corneal graft rejection most often occurs after 2 weeks and within 1 year post-operatively, but rarely may occur as late as 20 years following corneal transplant. Pain, light sensitivity, redness, and decreasing vision are warning signs of corneal tissue rejection and indicate the need for immediate medical attention. When started at the first signs of tissue rejection, steroids (drops, pills) are most often effective in halting the rejection process. If the rejection process does result in graft failure, leaving a donors tissue opaque, in resulting in blurry vision. Usually a repeat transplant may be performed, often with good visual results. Fortunately, only about 1 in 10 graft rejections episodes, "21% of total corneal transplants" results in complete failure of the transplant. top of pageConvalescenceThe eye is patched overnight and examined the next day. Usually, there is little or no discomfort after surgery.In most cases, resumption of normal activities may occur soon after surgery with some reasonable limitations. For example, lifting heavy objects or strenuous exercise must be avoided until directed otherwise by the physician (usually 6 to 8 weeks). Until the eye has healed, glasses or an eye shield must be worn to protect the eye. For several weeks following the transplant surgery, eye drops will be prescribed. The eye drops are to prevent infection and rejection of the donor corneal tissue. The sutures used to sew the donor cornea in place are barely visible and do not cause pain. It is normal for the eye to feel scratchy or irritated for the first few days following surgery. As the cornea heals, some of the stitches used to sew the donor tissue into place may need to be removed. This can be done quite easily and painlessly in the doctor's office. During the first few weeks after surgery, vision is usually quite blurry. It takes time for the eye to completely heal after surgery. It may take four to six months or occasionally longer for the cornea to stabilize although patients generally note steady improvement with time. Once the cornea stabilizes, improved vision is usually achieved. Glasses or contact lenses may be required for best vision post-operatively. top of page |