Cornea Transplants

Cornea Transplant

Definition, types, risks, benefits and more…

What is a corneal transplant?

  • First off, the cornea is the front clear surface of your eye—like a windshield. A corneal transplant is when the diseased cornea is replaced with a clear healthy cornea from a donor (think of it like getting your cars windshield replaced). The donor is someone who chooses to donate his/her corneas after death.

The different types of transplants…

  1. Full thickness or Penetrating Keratoplasty (PK): this replaces the full cornea when both the front and inner layers are damaged. There is a longer recovery period than others and getting back to full vision back after a PK may take up to one year or longer. This has a higher chance of rejection.

  2. Partial Thickness or Deep Anterior Lamellar Keratoplasty (DALK): when both the front and middle layers are damaged and the endothelial layer is kept in place. This is commonly used to treat keratoconus or bulging of the cornea. The healing time for a DALK is shorter than that of the PK. There is also less risks of rejection.

  3. Endothelial Keratoplasty: when the innermost layer is damaged, causing the cornea to swell, affecting your vision. The 2 types of endothelial keratoplasty are:

    • Descemet’s Stripping (Automated) Endothelial Keratoplasty (DSEK or DSAEK)

    • Descenmet’s Membrane Endothelial Keratoplasty (DMEK)

    Each type removes damaged cells from an inner layer of the cornea by a small incision and much of the cornea is left untouched—which lowers the risk of having the new cornea cells being rejected after surgery. A few stitches—if any— are needed to close that incision. In a DSEK/DSAEK the donor tissue may be easier to transplant and position because it is thicker then the donor tissue in a DMEK surgery. In the DMEK surgery, the tissue is thin and can be more difficult to transplant but the recovery period is quicker.

Dr. Bhasin will determine which surgery is best for you.

why would i need a corneal transplant?

Some reasons as to why you may need a corneal transplant can be:

  • corneal swelling

  • Keratoconus

  • Fuchs’ Dystrophy

  • bullous keratopathy (blister-like swelling)

  • eye infections that cause scars on the cornea (corneal ulcers)

  • previous corneal surgery or other eye surgery that damaged the cornea

Some people may need more than one corneal transplant. With that said, a repeat transplant has a higher rate of rejection than the first one. As far as the prognosis for corneal transplants, the long-term success depends on factors such as:

  • the underlying cause of the corneal damage

  • immune system acceptance of the donor transplant

  • surgical technique

benefits

  • Improve vision

  • Reduce eye pain (in very rare circumstances)

  • Improve the appearance of a damaged or diseased cornea.

RISKS include but are not limited to…

  • Rejection- when the body’s own immune system sees transplanted tissue as something that shouldn’t be there and tries to get rid of it.

  • Blurry vision

  • Infection

  • Bleeding

  • Eye pain

  • Extra sensitive to light

  • Redness

  • Detached retina

  • Glaucoma (increased eye pressure)

What to Expect After Surgery

After surgery care, post-op appointments, etc.

Cornea transplants are typically performed by ophthalmologists who specialize in corneal surgery. After the surgery, patients will need to follow a strict post-operative care regimen, which may include the use of medications to prevent infection and rejection of the transplanted tissue.

Recovery

After surgery you are asked to refrain from the following:

  • heavy lifting

  • bending

  • straining

  • swimming

  • hot tubing

  • getting water in your eye

  • no flying or scuba diving

  • no eye makeup for 1 week

You will also be given eye drops to use before and after surgery.

Each persons eyes heal differently and it is okay if it takes your eye more or less time to heal. For the post-op appointments you will be seen 1 day after surgery, 3 days after surgery, 1 week after surgery, and 1 month after surgery. Depending on the type of transplant you received it can take up to a year to completely heal.

references

professional, C. C. medical. (n.d.). What is a cornea transplant?. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/17714-cornea-transplant

Boyd, K. (2022, October 11). About Corneal transplantation. American Academy of Ophthalmology. https://www.aao.org/eye-health/treatments/about-corneal-transplantation

Arpita Bhasin